National Patient Safety Alert: Elimination of bottles of liquefied phenol 80% (25 August 2021)

Summary

A National Patient Safety Alert has been issued on the elimination of bottles of liquefied phenol 80%. The alert has been issued by the NHS England and NHS Improvement National Patient Safety Team, British Orthopaedic Society, The Association of Coloproctology Great Britain and Ireland, and Royal College of Podiatry.

Content

Following incidents where bottles of liquefied phenol 80% were either confused with other medication or caused burns when spilt, this alert asks providers to eliminate its use and to follow professional guidance to use safer alternatives.

Phenol, a caustic compound used for its antimicrobial, anaesthetic, and antipruritic properties, is highly toxic and corrosive. Liquefied phenol 80% can cause burns, severe tissue injury and is rapidly and well absorbed causing systemic toxicity. It is most commonly used in podiatry and orthopaedic foot surgery for destroying the nail matrix.

Actions to be completed as soon as possible and no later than 25 Feb 2022:

• Identify where liquefied phenol 80% is used and update procedures/guidelines to substitute use for a safer, suitable alternative.
• Ensure clinical areas have stock of agreed safer alternatives and then remove bottles of liquefied phenol 80% from clinical areas, and update stock lists.
• Amend electronic prescribing systems to ensure liquefied phenol 80% cannot be prescribed.
• Amend current purchasing systems, and introduce ongoing controls on purchasing, to ensure liquefied phenol 80% cannot be purchased inadvertently via the pharmacy department or any alternative purchasing route.