TOXBASE Primary Questionnaire

Question 1
What grade are you? / FY1 / FY2 / GPVTS / Core trainee / ST4-6 / Specialty / Consultant
Number of responses / 1 / 4 / 0 / 16 / 5 / 0 / 13
Percentage (%) / 3 / 10 / 0 / 41 / 13 / 0 / 33
Question 2
Roughly how often do you see a patient with an overdose? / Daily / Weekly / Fortnightly / Monthly / Rarely
Number of responses / 3 / 7 / 5 / 21 / 3
Percentage (%) / 7.7 / 17.9 / 12.8 / 53.8 / 7.7
Question 3
Do you normally look up the drug taken in overdose / Yes / No
Number of responses / 25 / 14
Percentage (%) / 64 / 36
Question 4
If so, which resource do you use? / BNF / Google/ internet / Wikipedia / TOXBASE / Medline / Poisons helpline / Maudsley / Oxford Handbook / Trust website / None
No. of responses / 9 / 5 / 7 / 1 / 2 / 1 / 1 / 1 / 1

NOTE Qu 3 had total 22 responders out of 39. Some had multiple answers

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? / Yes / No
Number of responders / 16 / 23
Percentage (%) / 41 / 59

Question 7. Have you ever tried to get onto TOXBASE, if so, what problems have you encountered?

  • 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 / Yes / No
Number of responders / 38 / 1
Percentage (%) / 97 / 3

Question 9. Do you have any examples of a time when TOXBASE could have been useful?

  • 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 suchas 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
  • 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? / No / GenMedRx is more applicable to most Psychiatrists / Cardiff Poisons Unit / Poisons Unit / Not sure/ blank
Number of responders / 33 / 1 / 1 / 1 / 3
Percentage (%) / 84.6 / 2.5 / 2.5 / 2.5 / 7.7