Clinical toxicology consultation by pharmacists

Area of Science:

• Clinical Toxicology
• Pediatric Emergency Medicine
• Pharmaceutical Sciences

Background:

• Clinical toxicology services are essential for managing poisoning cases.
• The specific roles and impact of pharmacists in these services require further elucidation.
• Pediatric poisonings present unique challenges necessitating specialized consultation.

Purpose of the Study:

• To describe the functions of pharmacists within a clinical toxicology consultation service.
• To evaluate the contributions of pharmacists in managing pediatric poisoning cases.
• To assess the perceived value of pharmacist involvement by healthcare professionals.

Main Methods:

• A six-month prospective study of pharmacist consultations in a children's hospital emergency department.
• Data collection included case details, pharmacist interventions (bedside vs. telephone), and etiology of exposure.
• Physician and nurse satisfaction surveys were used to rate pharmacist contributions.

Main Results:

• Pharmacists provided consultation for 189 poisoning cases, with 80% managed at the bedside.
• Drugs were implicated in 58% of exposures; pharmacists responded rapidly (median 5-10 minutes).
• Physicians and nurses reported favorable perceptions of the pharmacists' contributions.

Conclusions:

• Pharmacists effectively assist in history taking, toxicologic assessment, and management planning.
• Pharmacist involvement in clinical toxicology, particularly in pediatrics, is valuable and well-received.
• These findings support the integration of pharmacists into multidisciplinary toxicology teams.