New York State Poison Control Network - Annual Report on 2001 Data
Services Provided by Poison Control Centers
Each of the five (5) regional poison control centers is staffed by a Board Certified Medical Director, a Clinical Board Certified Managing Director, a team of Specialists in Poison Information, Health Educators, and support staff. For the Education Center, there is a Health Educator and support staff. In New York State, the poison control centers perform the following services:
Centers publicize their emergency telephone numbers and services to the general public and to health care professionals. The American Association of Poison Control Centers has initiated a new national toll free number (1-800-222-1222) that allows anyone access to their local poison control center. This is similar to the 911 or 411 process. The national toll free number was activated in New York State in June 2001. This new toll free number was tested during the events of September 11, 2001. With the loss of Tower II and the Verizon buildings, the majority of local phone service to the New York City and Long Island poison centers decreased and calls were intermittent. Fortunately, the toll free calls were easily re-routed to other Network poison centers allowing for no loss of calls. All of the Network centers have maintained their local pre-existing numbers in addition to the toll free number. The Network has also developed a backup system where, in case of telephone failure, local calls can be automatically re-routed, as well.
Distribution and advertising of the new phone number has begun and usage is being documented. This system will also allow the Centers to share educational and awareness materials. As always, each Center's emergency telephone numbers are listed on the inside front section of all local telephone directories and is provided to all telephone operators. Centers also have telecommunications that allow contact with hearing impaired persons. Commercial translation services are used by centers with a large number of foreign speaking populations.
Specialists in Poison Information (registered nurses, pharmacists, physician assistants, and/or physicians) are trained in toxicology, certified by examination, and answer incoming calls to the poison control center. Services include the provision of:
- expert telephone consultation for emergency poison exposures and inquiries 24 hours per day, seven days per week to health care professionals and the public;
- assessment of the risk of toxicity associated with poisoning emergencies;
- home treatment information to the public and clinical consultation to health care professionals;
- ability to recognize potential epidemics, biological and/or chemical terrorist events.
The following case illustrates the cooperation amongst health care professionals, the patient and the poison specialist:
Case: In early September, the poison center received a call from a doctor in a local emergency department from a family member of a patient who was vacationing in Thailand. Apparently, she was stung by a sea urchin and was in considerable pain. The certified poison information specialist (CSPI), who received the call, made a three-way connection between the patient in Thailand and the physician in the emergency department so an accurate assessment of her injuries could be made. After a few minutes, the poison specialist made the recommendation of hot water soaks, removal of the spines, and a pain reliever for the discomfort.
Poison control centers have immediate access to on-line and print toxicology resources, which display the most current information on more than 500,000 products, drugs, plants, and environmental toxins. The centers are supported 24 hours per day, every day, by medical and clinical toxicologists, and have access to expert consultants in specialties such as plants, mushrooms, snakes, insects and environmental and industrial toxins.
Crisis intervention services:
- serve as a source of information on life saving antidotes and vaccines;
- contribute to reducing health care costs by avoiding visits to emergency departments or other health care settings;
- provide drug information for the public and health care professionals;
- serve as resource for chronic lead poisoning and other environmental toxins;
- serve as a resource for substance abuse information and management;
- provide reporting, surveillance and act as an early warning network for the following: pesticide exposures, food poisoning episodes, substance abuse, herbal products and alternative medicine, biological and chemical warfare terrorist attacks, and exposures associated with malicious acts;
- cooperate in reporting all clusters of similar exposures and hazards to government agencies including the FDA, CPSC, OSHA, EPA, CDC, Department of Environmental Conservation, and local and state health departments.
Education and Research
- provide professional education to medical students, physicians, pharmacists, nurses, and other health care professionals;
- identify new toxic risks;
- conduct research to better prevent poisoning and enhance the management of poisoned persons;
- participate in nationwide sharing of data regarding poisonings;
- promote poisoning prevention among the general public;
- have an analytical toxicology laboratory available.
Most emergency calls to the centers are managed by poison specialists over the phone, avoiding expensive visits to a health care facility. Center staff follow-up on the patient's status by calling them at home at regular intervals to ensure the patient's welfare. If staff assess that further evaluation or treatment by a physician is necessary, they refer the caller to the nearest health care facility capable of providing appropriate care; call that facility to inform the staff of the referral; if necessary, arrange for emergency transportation of the patient. Patient status is monitored by the specialists until the patient is released from the treatment facility. The poison control centers provide expert consultation to health professionals in emergency departments and other health care settings 24 hours per day, seven days per week. Centers conduct product surveillance for use as early warning systems.
The medical and managing directors play important roles in the centers by providing expert toxicology in-service training, hands-on intervention with patients at host facilities, and consultations for health professionals from their own hospitals and from other health care facilities. This vital service provides medical students and residents with hands-on experience in management of poisoned patients, thus helping prepare physicians and future toxicologists. In addition, medical and managing directors meet with members of the community they serve including EMS providers, 911 communication centers, city, county and regional emergency management agencies, health care provider users and advocacy groups.
Health educators at each of the centers conduct extensive community outreach and education regarding the services provided by the centers and the prevention of poisoning. The health educators are responsible for promoting the center's emergency telephone numbers throughout their region. Now with the new national toll free number, the health educators are in the process of developing new materials that reflect the toll free number. This way, the materials will be distributed on a statewide level for continuity. In addition, the health educators facilitate poison prevention/awareness events and deliver education programs that target teachers, children, parents and care givers.