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Poison Control Centers (PCCs). Outline. History Functions of PCC PCC Certification Poison center case management Comparison between PCC and DIC Considerations of PCC. History. 1953 The establishment of the First PCC

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outline
Outline

History

Functions of PCC

PCC Certification

Poison center case management

Comparison between PCC and DIC

Considerations of PCC

history
History

1953 The establishment of the First PCC

1958 Formation of American Association of Poison Control Centers (AAPCC)

1978 661 poison centers in the USA

2000 A single nationwide toll-free telephone number providing access to poison centers in all 50 US states

poison control centers
Poison Control Centers
  • PCCs are established for two reasons:
    • To provide rapid access to information valuable in assessing and treating poisonings
    • To assist with poisoning prevention
functions
Functions

Assessment and treatment recommendations for poisoning via 24-hour emergency telephone services

Providing public and professional educational programs

Collecting data on poisonings for research

Training healthcare professionals

Assisting the public and health care providers during hazardous material spills

poison centers certification
Poison Centers Certification
  • AAPCC provides a program that certifies regional poison centers
  • Criteria for Certification:
    • Demonstration that the center is used appropriately throughout the region
    • Adequate staffing by specialists
    • Demonstration of the role of the physician
poison center certification
Poison Center Certification
  • Criteria for Certification- Cont’d:
    • Medical director in the operation of the center
    • Adequate training and experience of an administrative director
    • Demonstration of adequate programs in professional and public education
    • Participation in the AAPCC data collection
poison center case management
Poison Center Case Management
  • Receiving the call
  • Assessing history of exposure & potential for development of toxicity
  • Making a decision regarding the most appropriate location for continued care of the patient
  • Providing additional recommendations for patient management (observation, dilution, irrigation, emesis induction)
poison center case management1
Poison Center Case Management
  • Completing routine follow-up to monitor patient status (if observation/decontamination is recommended)
  • If expected response to home treatment does not occur, recommend transporting to ER
  • Informing the ER staff of patient’s status & providing initial recommendations for care
poison center case management2
Poison Center Case Management
  • Providing toxicology consultations in the hospital (bedside or by telephone)
  • Documenting all poison center interventions
comparison between dic pcc
Comparison Between DIC & PCC
  • Both have a common goal

“provide comprehensive, accurate, and timely information to their clients”

  • Both use the information

“to enhance the medical care of patients”

  • Both have similar

“information retrieval process and physical layouts”

  • Despite these similarities, there are a number of important differences between the two services

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

comparison between dic pcc cont d
Comparison Between DIC & PCC Cont’d
  • Clientele :
    • Public vs. health care professionals
      • 88% of PCC calls came from public
      • 9-10% of DIC calls came from public

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

comparison between dic pcc cont d1
Comparison Between DIC & PCC Cont’d
  • Call Volume :
    • Extremely large from public versus health care professionals
          • Average is 103 calls per day (human exposure only)
          • Range is 33 to 213 calls per day

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

comparison between dic pcc cont d2
Comparison Between DIC & PCC Cont’d
  • Hours of Operation/Cost :
    • PCC operates 24 hrs a day year-round vs. 9 AM to 5 PM
    • PCC requires large staffs compared to DIC
    • PCC is more expensive to operate than DIC

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

comparison between dic pcc cont d3
Comparison Between DIC & PCC Cont’d
  • Staffing :
    • PCC relies not only on pharmacist but also on other health care professionals with specialized training/certification (nurses, physicians, technicians)
          • Nurses worked 52% of the total phone hours in 1993
          • Pharmacists and physicians worked 36% and 3% of the total hours, respectively

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

comparison between dic pcc cont d4
Comparison Between DIC & PCC Cont’d
  • Response Time :
    • All PCC calls require an immediate response
    • Time is related to the efficacy of the therapeutic interventions
    • The average response time is 5 min in PCC vs. 15 - 30 min in DIC

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

comparison between dic pcc cont d5
Comparison Between DIC & PCC Cont’d
  • Call complexity :
    • PCC calls are less complex than DIC calls
      • Most poisoning patients rarely have complex medical history
      • Poisoning agents re-occur constantly from year-to-year
      • PCC is the first point of contact by public and health professionals

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

comparison between dic pcc cont d6
Comparison Between DIC & PCC Cont’d
  • References:
    • PCC assess and make treatment recommendation for any potential poison (medication, chemical, household, biological, natural toxin), But DIC handle medication and pharmacy-related inquiries
    • PCC will often have a broader base reference collection than DIC

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

comparison between dic pcc cont d7
Comparison Between DIC & PCC Cont’d
  • Documentation:
    • Documentation helps in developing a data system
    • General Epidemiological Data (date & time of call, reason for exposure)
    • Caller characteristics (site of call)
    • Patient characteristics (age, gender, pregnancy status)
    • Exposure characteristics (substance, route and site of exposure)
    • Clinical course (clinical manifestation, medical outcomes)
    • Medical management characteristics(therapeutic intervention)

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

considerations of pcc staffing
Considerations of PCCStaffing
  • Medical director
    • Physician with fellowship/certification in medical toxicology
    • Duties include
        • Protocol review and approval
        • Audit of poison center recommendations
        • Availability for consultation on difficult cases
  • Administrative director
considerations of pcc staffing cont d
Considerations of PCCStaffing - Cont’d
  • 5-6 full time Specialists in Poison Information (SPIs) with specialized training:
    • Pharmacists
    • Nurses
    • Qualifications
          • AAPCC offers a certification examination for SPIs who:
            • Worked at least 2000 hours in a poison center
            • Managed at least 2000 cases
  • Public education coordinator
considerations of pcc
Considerations of PCC
  • Facility considerations :
    • Location (near ER, medical library, hospital pharmacy)
    • Work space and environment
  • Equipment :
    • Telephone system (direct with enough lines)
    • PC computer system and/or local area network (LAN)
    • Modem and facsimile machine
    • Internet access
    • Other (such as file cabinets, refrigerators)

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

considerations of pcc1
Considerations of PCC
  • Resources :
    • Two factors should be available in PCC
      • The experience and training of the specialist
      • The quality of the information available to the specialist

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

considerations of pcc2
Considerations of PCC
  • Resources :
    • Micromedex’sPoisindex (a database of more than 800,000 household products, chemicals, and medications)
    • Clinical Toxicology of Commercial Products
    • General clinical toxicology texts
    • Specialized toxicology texts
    • Internal protocol for handling certain poisons
    • Primary literature (case report)
    • On-call medical support and experts in the area

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

considerations of pcc3
Considerations of PCC
  • Policy and Procedures :
    • Different than DIC in almost all aspects
    • Can include:
        • Handling intentional exposure
        • Long term public education program
        • Release of PCC tape recording
        • Telephone system repair

Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation

conclusion
Conclusion
  • PCCs and DICs may have similar goals but differ considerably in functions, clientele, staffing and type of calls
  • PCC may be combined with DIC as a Drug and Poison Information Center (DPIC)
  • Appropriate utilization of PCC is associated with huge costs savings