Clinical Pharmacists: Essential During a Poison Outbreak
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EDITORIAL
Clinical Pharmacists: Essential During a Poison Outbreak Joanne C. Routsolias 1
&
Renee Petzel Gimbar 2 & Michele Zell-Kanter 3
Received: 21 May 2020 / Revised: 10 June 2020 / Accepted: 11 June 2020 # American College of Medical Toxicology 2020
Emergency medicine (EM) pharmacy services began in the USA in the 1970s [1–3]. Support for training and expansion of EM pharmacy services has significantly increased over the past 15 years, and these services are now available in the majority of US healthcare institutions [3]. The role of EM clinical pharmacists is multifaceted. They are essential in providing expertise in pharmaceutical care and heighten the level of medication safety for a variety of Emergency Department (ED) patients [4, 5]. To be successful, the EM pharmacist must possess a vast clinical acumen in critical care, medicine, and ambulatory care. In recent years, medication shortages on a local or national level have added to the complexity of caring for patients in hospitals and outpatient settings [6]. Reasons for shortages may include cost, supply chain interruption, or unexpected toxicologic and infectious outbreaks. The American College of Medical Toxicology (ACMT) recently issued important position statements about the potential impact on patient care and the healthcare system when crucial antidotal therapy and prescription drugs are not available [6, 7]. These ACMT position statements emphasized how shortages compromise the quality of patient care, threaten patient safety, and create a heavy financial burden on all parties involved [6, 7]. Clinical pharmacists possess the expertise to devise alternative pharmaceutical solutions when established treatments are not available. They help ensure patient safety and optimize patient care while limiting additional cost [5–7].
Supervising Editor: Mark B. Mycyk, MD * Joanne C. Routsolias [email protected] 1
Department of Emergency Medicine and Pharmacy, Cook County Health, 1950 West Polk Street, 7th Floor, Chicago, IL 60612, USA
2
Department of Pharmacy Practice, UIC College of Pharmacy, 833 S. Wood Street, Suite 164, Chicago, IL 60612, USA
3
Department of Emergency Medicine, Cook County Health, 1950 West Polk Street, 7th Floor, Chicago, IL 60612, USA
Our involvement in an outbreak of patients poisoned with long-acting anticoagulant rodenticide-tainted synthetic cannabinoids (LAAR-SC) in the Chicago area will illustrate the essential value of clinical pharmacists. In March 2018 patients presented to multiple local EDs with abnormal bleeding. This local outbreak quickly became a large regional outbreak involving many different public health agencies. Medical toxicologists and EM clinical pharmacists from the Toxikon Consortium at Cook County Health, the University of Illinois Hospital, and the Illinois Poison Center were involved in the management of 178 coagulopathic patients [8]. The Toxikon Consortium is a multidisciplinary collaboration of all toxicology resources and experts from these institutions. As EM clinical pha
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