Exploring the knowledge and practice of calcium channel blocker overdose management among South African Emergency Medicine doctors

Introduction: Calcium channel blocker (CCB) agents have a high mortality rate in overdose (OD) in comparison to other cardiovascular agents. Literature on the emergency management of severe CCB OD is scarce and largely restricted to high-income countries. Within the African context, enhanced knowledge regarding CCB ODs has the potential to reduce mortality and promote adherence to clinical guidelines, provided that practice-related barriers are concurrently addressed. This study aimed to assess the knowledge and practice of emergency department (ED) doctors in managing a CCB OD, use of high dose euglycaemic insulin therapy (HIET), and barriers encountered in CCB OD management. Methods: We conducted a prospective cross-sectional mixed methods survey among 119 South African emergency medicine doctors, from June 2021 until October 2021, to assess their knowledge and practice of managing CCB OD's, using a convenience sampling method. It was a self-administered electronic survey containing 39 questions, including demographics and a combination of open, closed and case-based multiple-choice questions. The closed and multiple-choice questions were analysed using descriptive statistics and chi-square tests to examine associations between demographic variables and responses. Open-ended questions were analysed using thematic content analysis. Results: = 39, 32.8%). Discussion: This study has highlighted the need to address ED doctors' knowledge gaps on CCB OD management, further emphasising the importance of clinical toxicology education in South Africa. Although up-to-date guidance is freely accessible, its consistent use appears limited, emphasising the need for improved dissemination and integration into everyday emergency medicine and toxicology practice.