Welcome

Welcome to the 4th issue of the Clinicians Health Channel Newsletter. This issue’s focus article is on Toxicology, Toxinology and Poisoning.
Contents
CHC resources on Toxicology, Toxinology and Poisoning
TOXINZ
POISINDEX (Micromedex)
Snake bite management in Victorian Emergency  Departments
Therapeutic Guidelines (eTG Complete)
Resource updates
Training updates
Feedback
The Victorian Poisons Information Centre (VPIC) is located at the Austin Hospital in Heidelberg. VPIC provides Victorians with information and advice about what to do if a person has been poisoned, has overdosed, has made an error with medicines or has been bitten/stung by a snake, spider, bee, wasp etc. For members of the public this includes telephone assessment, advice on first aid, with or without referral to a doctor or hospital. Information and advice is given to health professionals about formulations of products and management of patients who have taken an overdose, been exposed to poisons,been envenomed etc.
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CHC Resources on Toxicology, Toxinology and Poisoning

 

TOXINZ (Australian & NZ Poisons Information and Toxicology)
TOXINZ is an easy-to-navigate and well referenced resource that provides in-depth risk assessment and management advice for clinicians treating poisoned and envenomed patients. It lists over 190,000 chemical products, pharmaceuticals, plants, venomous creatures etc.Being a ‘local’ product, the management advice reflects contemporary Australian and New Zealand practice. An outstanding feature of TOXINZ is that Australian and New Zealand Poisons Information Centre (PIC) staff and toxicologists provide regular feedback to the TOXINZ editors to ensure that the resource is up-to-date, i.e. there is an inbuilt quality assurance/governance loop.If a new pharmaceutical or illicit drug comes to the attention of PIC staff or toxicologists, TOXINZ can search the literature and promptly produce and upload a monograph.
All monographs include information on: –

Description of the substance, including class and available formulations.
Intervention criteria, which is particularly useful for risk assessment involving paediatric exploratory exposures. This section also includes observation period and investigations to be performed.
Treatment, including stabilisation, decontamination, antidotes, supportive care, prognosis, follow-up etc.
Signs and Symptoms, including onset and duration of symptoms, likely severity of poisoning.
Toxicity, including mechanisms of toxicity, acute and chronic scenarios etc.
Therapeutic Drug Information, including pharmacological action, indications, normal dose range, kinetics etc.
Identification, including chemical name, other names, identification codes.
References, which are embedded in the text, are listed at the end of each monograph.
POISINDEX (Micromedex)
POISINDEX (Micromedex) is produced in the US and is an evidence-based resource to help identify, manage, and treat toxicological exposures. It includes information on 350,000+ commercial products, chemicals, drugs, toxic plants, and animals. It also provides data on clinical effects, range of toxicity, and treatment protocols for poison exposure. POISINDEX database is linked to additional databases, such as Hazardtext® (for incidents such as spills, leaks, fires, or explosives involving hazardous materials) and Meditext (to assist in evaluating and treating acute exposures to industrial chemicals, reporting potential adverse health effects, and treating chemical release exposures).
Snake bite management in Victorian Emergency Departments
The Emergency Care Clinical Network (ECCN) has recently updated clinical pathways for suspected snakebite and snakebite envenomation in Victoria. Management flow chart and clinical pathways for suspected and snakebite envenomation – provides a practical approach to diagnosis and treatment including clinical envenoming, appropriate investigation and exclusion of envenoming in suspected snakebite cases, choice and dosing of antivenom. Information for patients with suspected or confirmed snake bite presenting at an Emergency Department. Read more >>
Therapeutic Guidelines (eTG)
The Therapeutic Guidelines (eTG) provides comprehensive information related to poisonings in the Australian context, including guidelines and management strategies, in its Toxicology and Wilderness section. These topics have been reviewed by an expert writing group for Therapeutic Guidelines: Toxicology and Wilderness, version 2. Read more >>
The Toxicology and Wilderness information includes risk assessment, first aid, hospital management, investigations, details of individual medications poisonings, other chemical poisonings, snake and spider bite management, marine envenomation, resuscitation guidelines, paediatric poisonings. It is easily searchable by browsing the index of the Toxicology and Wilderness section, or by entering a symptom, condition or drug into the keyword search box.
Resource updates

Austin Health Toxicology Guidelines were recently added to the Toxicology, Toxinology and Poisoning resources available on CHC. The Austin guidelines aim to provide Victorian emergency and critical care clinicians with up-to-date, concise information regarding care of acutely poisoned patients. The guidelines are written by an expert group of Austin Health clinical toxicologists and specialists in poisons information from the Victorian Poisons Information Centre (VPIC). There are robust governance processes underlying the development and ongoing review of the guidelines. All members of the development group are actively involved in the management of patients affected with poison within Austin Health and Australia wide, and all members are actively involved in toxicology research.

After initial drafting, each guideline is systematically reviewed by all members of the expert group before publication. They are reviewed and updated accordingly every 2 years. In addition, users are invited to provide feedback via an embedded email link. Feedback is reviewed monthly and may lead to a guideline amendment as required. In addition, guidelines may be updated as necessary following publication of new information.

There are currently about 40 guidelines available; more will be added over time. The guidelines will be an excellent resource for Victorian hospital clinicians and supplement the existing CHC Toxicology, Toxinology and Poisoning resources.

 

New BMJ Best Practice app launch
The BMJ Best Practice App was launched in February 2017. The old app will soon cease to work or update. Users of the old app were contacted directly by the BMJ and were prompted in the old app to update to the new app. Read more >>
JAMA Report Tutorials
The JAMA Report is a weekly video and audio new release highlighting studies appearing in the JAMA (Journal of the American Medical Association. The JAMA Report uses interviews with researchers and patients to summarize important findings from new research and review articles. Broadcast-quality files are made available for download free of charge along with B-roll, scripts, and other images. Access JAMA Report tutorials here
Pregnancy and Breastfeeding Medicines Guide (PBMG)
Five new medicine profiles, ferric carboxymaltose, iron polymaltose, iron sucrose, polystyrene sulfonate resins and sucroferric oxyhydroxide have been added online. The Medicines used for anaemia therapeutic group has been added to the website to aid in the management of this condition during pregnancy and breastfeeding. All 22 vaccines, 13 analgesics and 28 anaesthetics medicine profiles have been recently reviewed and updated to provide the latest information and recommendations for use in pregnancy and breastfeeding.
Training updates

For complete list of upcoming training events check out at CHC Knowledge Hub. To request training at your location please contact the Education Manager.

Apr 3rd
2017
PsycInfo on Ovid
Topic: This class highlights the unique structure of this database and includes a detailed review of specific limits, fields and search tips for this resource.
To register click HERE

From 9:00 AM
Apr 3rd
2017
Introduction to Ovid
Topic: Introduction to Ovid
Description: Designed for novice users or experienced users who may need to refresh basic skills. This course will highlight the features and functionality of the Ovid interface including: NLP searching, Search Tools and mapping, Results Management Tools, Linking to Full Text and multiple options in outputting the results received.
To register click HERE

From 11:00 AM
Apr 4 th
2017
MEDLINE on Ovid
Topic: MEDLINE on Ovid
Description: Designed for more experienced users familiar with the basic functionality of Ovid. Includes a detailed search demonstration of MEDLINE using Ovid’s features.
To register click HERE

From 11:00 AM
Feedback

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