We noted a lower propensity for ordering AChE in those with the most experience compared those with no test experience, a difference which approached statistical significance (OR 0.78 [0.61-1.00], p = 0.052), when level of experience with seeing AChE test was considered.
We surveyed 23 clinicians, who had different levels of exposure to seeing AChE levels in OP poisoned patients, on a) knowledge of OP poisoning and biomarker interpretation, b) attitudes towards AChE in guiding poison management, oxime therapy and discharge decisions, and c) practices of ordering AChE in poisoning scenarios.
The survey had 3 components:- 1) 25 True/false statements (worth 1 mark each) organized into 5 questions on knowledge of OP poisoning, use of oximes and AChE testing 2) Short answer questions assessing attitudes towards AChE testing and choice of oxime therapy 3) Scenario based questions assessing clinical practice regarding ordering AChE tests, oxime therapy, and patient discharge.
"Time" (since admission) was a factor affecting whether respondents would order an AChE test, with a lower propensity for ordering an AChE test each subsequent day in the hospital admission (OR 0.85 [0.79-0.91], p < 0.001, see Figure 5).
An ascending order of AChE inhibition with the increased concentration of arsenic in Channa punctatus was mentioned by Roy et al. (2006).
"can discharge the patient early" "it would decide in keeping or discharging the patient" Respondents qualified their answers with clarifying comments for just under half (48%) of the scenario questions in favor of the decision to order an AChE test, with 48% (see Additional file 5: Figure S3), providing some insight into the thinking behind ordering and not ordering an AChE test.
This was not the case as respondents suggested they would order an AChE test on only 38% of occasions (6/16) where they said they would discharge a patient home, and there was no association between the decision to order an AChE test and the decision to discharge (see Figure 6).
If French students and workers were appalled by the European bourgeois order, Czech students ached for a return to European civilization.
Typing in orders had made my backside ache from all the sitting; after the shift in duties, I was on my feet all day, carrying, bending, lifting and crouching.
Conversely there was an increased propensity for ordering an AChE test with greater severity of poisoning (OR 1.22 [1.10- 1.37], p < 0.001).
