Safety recommendation
It is recommended that the Association of Ambulance Chief Executives works with the National Poisons Information Service to review its guidance on the treatment and transportation of patients known to have taken an overdose of propranolol or other beta blocker medication.
Response:
The AACE develop and publish clinical guidelines, and these are used by ambulance clinicians and paramedics across the NHS ambulance services to guide patient care. The guidelines include a range of conditions that may result in someone calling for an ambulance for, such as cardiac arrest, trauma, maternity, overdose and poisoning and many more.
The AACE liaised with the National Poisons Information Service and consulted with two of their leads that had previously supported with the UK ambulance clinical guidelines, specifically the guidance around people that call for an ambulance in an overdose or poisoning situation.
The AACE reviewed the existing section in the specific substance management of the overdose and poisoning guideline that relates to beta blockers.
The AACE revised this section and added the names of common beta blockers and that they commonly ended in ‘olol’ such as propranolol. It enhanced and added extra wording around the signs and symptoms and management of patients that have taken an overdose of beta blockers to further emphasise the dangers and the serious effects that can occur.
The AACE also added a new general point regarding slow-release medicines to highlight that they may have a delayed clinical effect.
The revised guidance was issued onto the JRCALC App which is used across the UK by ambulance service clinicians on 16 June 2020. The App contains the full set of clinical guidelines and is used frequently by ambulance clinicians.
Response received on 3 July 2020.