Poisoning
Conditions
Interventions
We will do a three arm clustered randomised trial of educational interventions in 106 primary rural hospitals in three non-contiguous provinces in Sri Lanka (North Western Province, North Central and
all with prompts to look-up the National Poison Guidelines). This would be followed up one year later with a refresher session in a similar format.
Primary Intervention 2 - Centralised Further Educat
Sponsors
South Asia Clinical Research
Eligibility
Inclusion criteria
Inclusion criteria: All primary rural hospitals with inpatient treatment facilitie
Exclusion criteria
Exclusion criteria: None
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Use of forced emesis and/or gastric lavage : a. Documentation of primary hospital charts b. Validation by history of intervention in the subset transferred to referral hospital [6, 12, 18 & 24 months] Use of activated charcoal: a. Documentation of primary hospital charts b. Validation by history of intervention and examination (for evidence of charcoal ingestion) in a subset transferred to referral hospital [6, 12, 18 & 24 months ] Use of pralidoxime: a. Documentation of primary hospital charts b. Validation by hospital pharmacy records and central pharmacy ordering. c. Detection of pralidoxime in blood samples in the subset transferred to referral hospital [6, 12, 18 & 24 months ] Use of oral methionine or n-acetylcysteine: a. Documentation of primary hospital charts b. Validation by hospital pharmacy records and central pharmacy ordering [6, 12, 18 & 24 months] Rate of inter-hospital transfer for paracetamol poisoning [6, 12, 18 & 24 months ] | — |
Secondary
| Measure | Time frame |
|---|---|
| Deaths from poisoning a. Documented in primary and referral hospital charts and from interhospital ambulance transfer records [6, 12, 18 & 24 months] Extent of irreversible red cell acetylcholinesterase inhibition at admission [6, 12, 18 & 24 months ] Economic Analysis: a. Hospital based direct costs of antidote maintenance and patient related costs such as transport would be estimated. [6, 12, 18 & 24 months ] Persistence of behavioural change. a. The magnitude of effect would be measured over time in each intervention group and in the control to determine if the behavioural change is maintained. [6, 12, 18 & 24 months ] Factors that may influence the extent and persistence of behavioral change. a. We will (post hoc) examine how variable the effect is and whether factors such as hospital size, staffing, patient load and proximity to referral centres correlate with the extent of behavioural change. b. We will also (at the end of the intervention and at the end of data collection) undertake focus group discussions in hospitals with high and low rates of change from each arm of the trial. These discussions will involve standard qualitative research analysis techniques to bring out the main thematic elements in the perceptions of the participants in terms of the success or failure of particular interventions. [6, 12, 18 & 24 months ] | — |
Countries
Sri Lanka
Contacts
Public ContactAndrew Dawson
Professor, Clinical School, UNSW
Outcome results
None listed