Availability of antidotes in French emergency medical aid units

OBJECTIVE: To study the availability of antidotes in French emergency medic al aid units (SAMU). METHODS: The physicians or nurses responsible for antidotes in French emerg ency medical aid units (SAMU) were interviewed by phone. The study involved 102 SAMU in metropolitan France. Four answers on availability of 37 antido tes were possible: the antidote was available in the emergency vehicle used for interventions; the antidote was available in the hospital-located SAMU ; the antidote was available in the referral hospital (emergency unit, inte nsive care unit, operating room, pharmacy); the antidote was not available or not known to be available. RESULTS: Adrenaline and atropine were available in ail the intervention veh icles. Nine other antidotes were available in more than two-thirds of the v ehicles: 30% glucose (101/102), isoprenaline (100/102), dobutamine (98/112) , sodium bicarbonate (97/102), naloxone (95/102), calcium chloride or bicar bonate (89/102), flumazenil (83/102), sodium lactate (77/102), and magnesiu m sulfate (66/102). Among the other antidotes, hydroxocobalamine and propra nolol were available in 24/102 intervention vehicles and activated charcoal in 22/102. Antidigitalic antibodies and 4-methylpyrazole were not availabl e in any vehicle, and were available in less than 25% of the hospitals. CONCLUSION: There is a great disparity of antidote availability. Certain es sential antidotes, for which there is no alternative, are not available in emergency intervention vehicles and even in the hospital. The SAMU should d evelop an economically acceptable departmental management scheme for except ional-use antidotes.