Medical providers, especially those working in an emergency care, have been called at least once about a patient with some kind of medication overdose. Whether it was an overdose with opioid pain medications, or too much beta-blockers in a hospitalized patient with renal dysfunction, or a patient showing up in ER after ingesting some medication or a chemical. Your general knowledge reminds you that naloxone is the antidote of narcotic overdose and glucagon is for beta blockers. But what dose you should initially give, at what frequency, and what should you suggest about follow up? There's too many questions, and you, as a medical practitioners, are not supposed to know all the answers.
Fortunately, the Antidote Toxicology App comes to the rescue. This app was created in 2015 by the Toxicology Section of the American College of Emergency Physicians (ACEP), with a goal to ease the workday of all Emergency care providers in need of quality antidote guide. And it really puts some relief on our shoulders, especially knowing how difficult it was finding an accurate toxicology guide some time ago, even if you searched by exact keyword.
As its creators describe it, the Antidote app is a succinct resource designed for quick access to indications and dosing regimens for a variety of medications and antidotes used for common poisonings encountered by emergency care providers. All the questions we asked above, as well as the questions that emergency care provider may ask about the variety of antidotes, doses and re-doses, or infusion rates, are neatly packed in this app, which also provides all the necessary answers.
Upon starting the app, a simple screen welcomes you with only a search function. If you feel unimpressed, you shouldn't be. This is exactly our favorite aspect of this app. It's simple and straightforward. It does exactly what it's designed for.
The search function allows you to search for specific antidotes by entering certain keywords. The medications or drugs suspected of being a cause of poisoning or an overdose are usually a good starting point. So you can start by typing one of them, such as Aspirin, beta blocker, Tylenol, etc.
You'll get the result depending on the keyword you asked. In case of aforementioned keywords, you'll get Glucagon, Sodium Bicarbonate or Acetylcysteine respectively. Taping on the result, provides you with more detailed information about the dosing and treatment regimen, as well as comments on side effects and potential contraindications with other drugs and patient conditions.
Of course, providers should check the specific dosing themselves to make sure it's correct when utilizing the app. Because, this app (as any other app or tool) should be considered only as a reference, not as a definite guide in dealing with medication overdose and its treatment with antidotes.
What is lacking in the results is more clinical information about the overdoses, such as Rumack-Matthew nomogram, which could be useful for Acetaminophen overdoses. We hope that future updates could fix this. But, considering the fact that the app is almost 2 years old, that might be unlikely.
Another thing that could be improved are pictures of key medications that could be useful addition, since patients or parents are often confused as to which medication was ingested.
Beside Search option, Emergency Care providers can search for individual antidotes from the menu (View All) that allows them to scroll through an alphabetized list of approximately 50 different antidotes from A (acetylcysteine) to T (thiamine). This is probably the most convenient way to use the app since providers probably already know the antidote for the toxic ingestion.
Users are able to add notes and guidelines for personal use within the app bu tapping on the 'Add a Note' at the top of the screen under the each antidote name itself. Notes will show up at the bottom of the page once saved.
App menu also offers a list of references used in creation of this app, as well as more info about the app itself and its creators, i.e. American College of Emergency Physicians.
Finally, another useful thing is a button below the Search field on the home screen. It allows you to call the Poison Control Center directly with just one tap.
Of course, clinical judgment is still required when considering the treatments and use of the antidotes, so this app is useful just as a reference, just as we said above as well as the app's ToS states.
Still, this is a great tool for all providers in need of concise antidote guide and we highly recommend it.
Benefit: The Antidote app is a good resource for emergency care providers to have easy access to dosing regimens for a variety of medications and antidotes used for common poisonings encountered in emergency medicine.