EMERGENCY DEPARTMENT USE OF FLUMAZENIL PRIOR TO POISON CENTER CONSULTATION

We studied the frequency of use of flumazenil by emergency departments in our region and compared it to recommendations made by specialists in poison information at our poison control center. For a 5-mo period, we prospectively collected cases involving benzodiazepines or zolpide m. Data was documented only from calls from emergency departments. Eme rgency department personnel were asked the following: if given, the do se and frequency, contraindications, and adverse reactions. Each case was followed to completion. Flumazenil was not given in 55 cases. Of t he remaining 14 cases in which it was given, 10 of the cases received flumazenil prior to poison control center consultation. We noted 1 cas e of dizziness. Ten cases given flumazenil had contraindications (eg e thanol abuse or possible seizurogenic coingestants). Despite possible contraindications, flumazenil was given 10/14 times (71%) prior to cal ling the poison control center. These results point to potential overu se of this antidote where contraindications or cautions are suspected in the overdosed patients. Our study suggests that when flumazenil use is contemplated by an emergency department physician, a poison contro l center consult may have a contrary recommendation.