Flumazenil use in an emergency department: a survey

Journal of Toxicology. Clinical Toxicology
M Mathieu-NolfD Mathieu

Abstract

To evaluate the efficacy of flumazenil use by a one-year survey of practice in tan emergency department. During a one-year period, an observational prospective study in the emergency department of an urban community hospital enrolled every patient admitted with a history of pure or mixed benzodiazepine acute poisoning. Case records were secondarily reviewed by an expert group. Actual flumazenil use during hospitalization was compared to currently recommended indications. In order to evaluate the efficacy of flumazenil use, patients who received flumazenil were matched with those who did not and effects on mortality, morbidity, number of costly procedures (CT scan, diagnostic toxicology, etc.) and duration of hospital stay were determined. Of the 1529 patients admitted in 1 year for acute poisoning, 478 reportedly ingested at least one benzodiazepine. Twenty-nine patients (6%) received flumazenil in the emergency department whereas the expert reviewers recommended flumazenil use in only 18 (3.7%). In 11/29 (38%) cases, the use of fumazenil was considered inappropriate. The expert group considered flumazenil to be contraindicated in 93 of 478 patients. Nonetheless, flumazenil was used in 11 patients (rate of potentially harmful f...Continue Reading

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Citations

Jul 7, 2012·The Journal of Emergency Medicine·Allyson A KreshakChristian A Tomaszewski
Aug 14, 2008·Basic & Clinical Pharmacology & Toxicology·Nese Colak OrayYesim Tuncok
Feb 28, 2007·The American Journal of Forensic Medicine and Pathology·D R Vantaggiato, N De Giovanni
Mar 23, 2006·The Journal of Applied Psychology·Leslie A DeChurch, Michelle A Marks
Jun 25, 2004·Journal of Toxicology. Clinical Toxicology·Donna L Seger
Apr 26, 2012·Pediatric Emergency Care·Allyson A KreshakF Lee Cantrell

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