Poison control center

For the indie rock band, see The Poison Control Center.

A poison control center is a medical facility that is able to provide immediate, free, and expert treatment advice and assistance over the telephone in case of exposure to poisonous or hazardous substances. Poison control centers answer questions about potential poisons in addition to providing treatment management advice about household products, medicines, pesticides, plants, bites and stings, food poisoning, and fumes. More than 72%[1] of poison exposure cases are managed simply by phone, greatly reducing the need for costly emergency room and doctor visits.[2]

History

After World War II there was a proliferation of new drugs and chemicals in the marketplace, and consequently suicide and childhood poisonings from these agents drastically increased. Around this time up to half of all accidents in children were poisonings with a substantial number of fatalities.[3] These factors led to the medical community developing a response to both unintentional and intentional poisonings. In Europe in the late 1940s special toxicology wards were set up; initial wards were started in Copenhagen and Budapest, and the Netherlands began a poison information service.[4] In the United States the first poison information center was started in Chicago in 1953.[5] By 1957 there were 17 poison control centers in the US, with the Chicago center serving as a model; these centers dealt mainly with physician enquiries by giving ingredient and toxicity information about products, along with treatment recommendations. Over time the poison control centers started taking calls from the general public. The majority of poison centers were not part of a patient treatment facility; they strictly provided information.

In 1958 the American Association of Poison Control Centers (AAPCC) was founded to promote cooperation between poison centers in different cities and to standardize the operation of these centers. An additional part of the AAPCC's activities was poison prevention and education programs for both physicians and the general public. In 1968 the American Academy of Clinical Toxicologists (AACT) was established by a group of medical doctors. The AACT’s main objective was to apply principles of toxicology to patient treatment and improve the standard of care on a national basis. In the 1960s and 1970s a rapid proliferation of poison centers emerged and by 1978 there were 661 centers in the USA. This trend reversed during the 1980s and 1990s with a number of centers closing or merging. In 2000 there were 51 certified centers in the USA.[6] Today there are 55 centers operating in the US.[7]

A similar movement evolved in Europe but unlike the American movement the majority were centralized toxicology treatment centers with integrated poison information centers. The French developed an inpatient unit for the treatment of poisoned patients in the late 1950s. In England the National Poison Information Service was developed at Guy's Hospital under Dr Roy Goulding.[4] At around the same time Dr Henry Mathew started a poison treatment center in Edinburgh.[8] In 1964 the European Association for Poison Control Centers was formed at Tours, France.[4][9] Australasian centers were also established in the 1960s. The New Zealand center started in Dunedin in December 1964, while in Australia, the New South Wales Poisons Information Center was established in 1966.[10][11]

Today

Poison control centers provide excellent service and savings. Recent research shows that every dollar invested in the poison center system saves $13.39 in health care costs and productivity.[12]

While poison control centers have traditionally provided expert consultations by telephone, on December 30, 2014 an online option was launched by a group of U.S. poison centers to meet the growing demand for accurate web-based health information.[13] webPOISONCONTROL® is a free, confidential, online triage tool also available as a downloadable app. Based on age, weight and substance implicated, it provides case-specific guidance for poison exposures – limited to unintentional, single ingestions of medicines, household products or berries in asymptomatic individuals. The application uses ingredient-based algorithms to generate a recommendation including whether an emergency room visit or call to poison control is required. If it’s safe to stay home, then home treatment recommendations, specific symptoms to expect, and symptoms of greater concern that would require a call to poison control or a visit to an emergency room are outlined.

USA

The American Association of Poison Control Centers manages a 24-hour hotline (1-800-222-1222), which is continuously staffed by pharmacists, physicians, nurses, and poison information specialists who have received dedicated training in the field of toxicology. Calls to the number are automatically routed to the poison control center that covers the territory from which the call is placed. It has a TTY/TDD number for the hearing impaired. Poison educators across the country also offer poison prevention training and education sessions to community institutions, along with educational materials.[14]

Rest of the world

Most countries have a poison control center with staffing similar to the American centers. A worldwide directory of poison centers is available from the World Health Organization's website.[15]

EU/EEA

Article 45 of the CLP Regulation places the duty upon Member States to appoint "bodies responsible for receiving information relating to emergency health response". These appointed bodies are often known as Poison Centres.

Belgium

Poison Centre (Centre Antipoisons, Antigifcentrum)

Germany

Federal Institute for Risk Assessment (BfR) (Bundesinstitut für Risikobewertung)

Italy

National Institute of Health (ISS) (Istituto Superiore di Sanità)

Netherlands

The National Poisons Information Centre (NVIC) of the University Medical Center Utrecht provides a 24/7 hotline service (030-2748888), staffed by poison information specialists (SPIs). It is open to medical professionals only and is not available to the general public.

Since 2011 the NVIC also provides a web-based exposure analysis and poison information system (http://www.vergiftigingen.info]. As with the webPOISONCONTROL system, this is a free-of-charge, fully confidential web application that enables medical professionals to quickly and efficiently assess the potential risks of (mixed) exposures, as well as their clinical signs and symptoms, and possible therapeutic interventions. As with the other online options worldwide, it remains advisable to consult the NVIC if the exposure is to a larger number of substances.

The NVIC can, on request, also provide specific training to emergency medical personnel (GMTs), emergency departments, physicians and their assistants, and other interested parties with regards to exposure prevention and management.

The NVIC was part of the National Institute for Public Health and the Environment until 2011. It was then transferred to the University Medical Center Utrecht.

United Kingdom

National Poison Information Service (NPIS)

Asia

Saudi Arabia:

The poison control department in King Fahad Medical City provieds its service for healthcare professionals 24/7 throughout the year.

Palestine

"The Palestinian Poison Control and Drug Information Centre" was established in 2006, by Ansam Sawalha.[16]

Footnotes

  1. ↑ "American Association of Poison Control Centers (AAPCC) National Poison Data System (NPDS) Annual Report". 2009.
  2. ↑ Miller T, Lestina D (1997). "Costs of poisoning in the United States and savings from poison control centers: a benefit-cost analysis". Annals of Emergency Medicine. 29 (2): 239–245. doi:10.1016/S0196-0644(97)70275-0. PMID 9018189.
  3. ↑ Grayson R (1962). "The poison control movement in the United States". Ind Med Surg. 31: 296–7. PMID 13901334.
  4. 1 2 3 Govaerts M (1970). "Poison control in Europe". Pediatr Clin North Am. 17 (3): 729–39. PMID 5491436.
  5. ↑ Press E, Mellins R (1954). "A poisoning control program". Am J Public Health. 44 (12): 1515–1525. doi:10.2105/AJPH.44.12.1515. PMC 1621008Freely accessible. PMID 13207477.
  6. ↑ Ford MD, Delaney KA, Ling LJ, Erickson T, eds. (2001). Clinical toxicology. WB Saunders Company. ISBN 0-7216-5485-1.
  7. ↑ Bronstein AC, Spyker DA, Cantilena LR, Green J, Rumack BH, Heard SE (December 2007). "2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS)". Clin Toxicol (Phila). 45 (8): 815–917. doi:10.1080/15563650701754763. PMID 18163234.
  8. ↑ Proudfoot A (1988). "Clinical toxicology—past, present and future". Hum Toxicol. 7 (5): 481–487. doi:10.1177/096032718800700516. PMID 3056845.
  9. ↑ Persson H (1992). "European Association of Poison Centres and Clinical Toxicologists". J. Toxicol. Clin. Toxicol. 30 (2): v–vii. doi:10.3109/15563659209038627. PMID 1588665.
  10. ↑ "History of the New Zealand Poison Centre". New Zealand National Poison Centre. Retrieved 2008-01-20.
  11. ↑ "About the NSW Poisons Information Centre". NSW Poisons Information Centre. 14 January 2008. Retrieved 2008-01-20.
  12. ↑ https://aapcc.s3.amazonaws.com/pdfs/member-resources/Value_of_the_Poison_Center_System_FINAL_9_26_2012_--_FINAL_FINAL_FINAL.pdf
  13. ↑ "webPOISONCONTROL®". NCPC. Retrieved 2015-06-02.
  14. ↑ "American Association of Poison Control Centers". AAPCC. Retrieved 2008-12-01.
  15. ↑ The International Programme on Chemical Safety. "World directory of poison centres". World Health Organization. Retrieved 2013-12-29.
  16. ↑ Sawalha, Ansam F. (1 November 2008). "Poison Control and the Drug Information Center: the Palestinian experience". Isr. Med. Assoc. J. 10 (11): 757–760. PMID 19070281 – via PubMed.

See also

External links

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