TOXBASE Primary Questionnaire
Question 1
What grade are you?
Number of responses
Percentage (%)
FY1
1
3
FY2
4
10
Question 2
Roughly how often do you see a patient
with an overdose?
Number of responses
Percentage (%)
GPVTS
0
0
Core trainee
16
41
ST4-6
5
13
Daily
Weekly
Fortnightly
Monthly
Rarely
3
7.7
7
17.9
5
12.8
21
53.8
3
7.7
Question 3
Do you normally look up the drug taken in overdose
Number of responses
Percentage (%)
Specialty
0
0
Yes
25
64
Consultant
13
33
No
14
36
Question 4
If so, which
resource do
you use?
BNF
Google/
internet /
Wikipedia
TOXBASE
Medline
Poisons
helpline
Maudsley
No. of
9
5
7
1
2
1
responses
NOTE Qu 3 had total 22 responders out of 39. Some had multiple answers
Oxford
Handbook
Trust
website
None
1
1
1
3 TOXBASE users stated that they used an access code from a different base.
Question 5
Have you ever used TOXBASE?
Yes
No
Number of responders
26
13
Percentage (%)
67
33
Question 6
Have you ever tried to get onto TOXBASE whilst in AWP?
Number of responders
Percentage (%)
Yes
16
41
No
23
59
Question 7. Have you ever tried to get onto TOXBASE, if so, what problems have you
encountered?
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No access
No login access - unsuccessful
I could not access Toxbase, this was very frustrating as I needed to give advice quickly and
trust the source of the information.
Have always asked ED staff however, it would be really useful. Have also called the
Birmingham toxicology centre who were quite adamant that we should have access to
Toxbase
I have tried to get onto TOXBASE when working on-call but not had a log-in username and
password. I used to have access when working in the ED in Cheltenham and this resource
was essential.
That you have to be a trust manager to set up an account!
I don’t have a log in
Usually use via A&E but would be helpful to have own access as well
The username and password that we were given when starting RUH didn’t work and haven’t
yet been able to sort
No log in
Not registered
Unable to - access it via NBT (North Bristol Trust)
I was unsuccessful as I did not know the login details. As I was most often in BRI or Frenchay
at the time I was able to use the resources of those trusts instead
I tried but unable to as no access code. So called national poisons hotline. Would have been
useful in two occasions at least - one double dosage of lithium and antipsychotics
inadvertently administered on inpatient psychiatric ward. Another time would have been
useful is when someone at home took OD and giving advice to intensive team about
whether she needed A&E or not.
No, as I have access
Need registration
In summary: 15 users had no access. 2 users got access to TOXBASE information via ED.
Question 8
Do you think it would be useful to have access to TOXBASE whilst
working in AWP
Number of responders
Percentage (%)
Yes
No
38
97
1
3
Question 9. Do you have any examples of a time when TOXBASE could have been useful?
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People taking overdoses in high security wards- several times. Working in A&E in the past it
was ESSENTIAL. I can't believe we don't have access to this.
Patient overdosing on ward
I borrowed a log in to Toxbase from my time working in ED at the BRI. I have come across
many ODs since working in AWP and would strongly recommend that junior docs get access
to Toxbase as a matter of course
More useful when on call or when more junior and saw more overdoses out of hours
During triage or op clinics when a patient discloses overdose a week or two previously and
we are not sure whether we should send the patient to general hospital to seek further
medical attention.
No, however mental health medics are one of few medical disciplines where their patient
group have either accidental/purposeful ODs (other inc ED, CoE) so access to clinical info on
TOXBASE or equivalent is important even though the frequency of use maybe low.
Toxbase is an essential resource and every hospital doctor should have access to.
Patients overdosing after coming back from leave giving advice to medical teams over the
phone.
No (x4 responders)
Overdose on inpatient ward of medication brought in, so that I could have managed the
acute presentation while waiting for ambulance more efficiently. In ED to check side effects
of a drug overdose that may affect my mental state exam.
Information is king [Presumably meant “key”]
There have been numerous examples of when it has been useful to look up TOXBASE. A
common example is when we are being asked to review a patient after an overdose and the
patient has been declared medically fit. Sometimes these patients are still experiencing
effects from the overdose and TOXBASE gives a description of the likely physiological effects
to look out for. This allows: - a better safer assessment of the patient - the ability to decide
what physiological changes are due to overdose medication, the patient's own medication or
possible organic causes - on occasion, the ability to decide that a patient is not medically fit
yet and discuss this with ED staff
Lots! Particularly in very small overdoses that are under the mg/kg level it would save staff
and patient time.
On call doing ED assessments When you are giving advice to GPs and to patients
If overdose disclosed in community to ascertain what medical f/u is required and how
quickly. When r/v patients in A&E and not able to talk to medics straight away - to
understand what medical input will be required and for how long. Would help to plan
mental health assessments.
Oncall- questions from staff involving overdose, time till discharge, side effects to be aware
of.
Called to patients on ward who may have over-dosed to determine if need to go to general
hospital
In the event of any overdose, medication or from drinking alternative substances such as
detergents
More useful as a trainee when I used to first interview the patient. Have used to determine if
appropriate to refer on to General hospital and find out what cumulative effect of various
overdosed meds would have on patient
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All overdoses
Seeing overdoses in A&E as a psychiatrist, and also when patients return from hospital
having taken an overdose.
Without having used it, I'm not sure of its parameters but if alternative to National Poisons
unit, then would use whenever seeing patient in overdose situation that hasn't been
assessed medically (especially e.g. in Out-patients when someone reports having taken
overdose recently).
Consumption of mouthwash on ward multiple overdoses
Regularly see patients who disclose overdose
MIXED OVERDOSES
No i work in old age psychiatry where this is quite a rare problem and as a community
consultant i only usually get involved once all medical issues have been sorted out
Working with Intensive Teams I have been asked to give medical advice on reported
overdoses that have been disclosed to them. Toxbase would be helpful in making this a
more informed decision.
Where a patient has taken a moderate overdose and I am unsure whether they need a
medical assessment or whether it is safe for them to go home
When patient outside of A&E, ie in inpatient unit or at home, takes an overdose. Then
instead of automatically having to call an ambulance and send them to A&E, could be useful
to know about
Yes and I used it
In deciding the rapidity of transfer to hospital when patient reports OD of OTC medication
multiple!
Question 10
Do you know of a better alternative to
TOXBASE which we could get access
to?
Number of responders
No
33
GenMedRx is more
applicable to most
Psychiatrists
1
Cardiff
Poisons
Unit
1
Poisons Not
Unit
sure/
blank
1
3
Percentage (%)
84.6
2.5
2.5
2.5
7.7