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Poison Centers as Partners in Rapid Response Situations

Poison Centers as Partners in Rapid Response Situations. Robert J. Geller, MD, FACMT Medical Director, Georgia Poison Center; Professor of Pediatrics, Emory University School of Medicine. Poison Centers in the US. There are 60 poison centers in the US

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Poison Centers as Partners in Rapid Response Situations

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  1. Poison Centers as Partners in Rapid Response Situations Robert J. Geller, MD, FACMT Medical Director, Georgia Poison Center; Professor of Pediatrics, Emory University School of Medicine

  2. Poison Centers in the US There are 60 poison centers in the US Service to all states, DC, and US territories, 24x7 Poison Centers are organized to serve specific geographic regions, with collaborative backup when needed Each independent poison center collaborates to supply data about calls handled to a central national database

  3. Poison Center Services Core services: Response to telephone inquiries about drug, chemical, other potentially toxic exposure Public education aiming at reducing incidence and severity of poisoning Added services from some centers: Animal bite triage Public health triage, data collection Disaster coordination assistance, such as facilitating access to regionally stockpiled antidotes

  4. Poison Center Service Metrics Annual volume > 4,000,000 calls nationally Automated surveillance at national level running continuously Of call volume per center Of substances reported involved per center Individual centers vary in size and call volume Range 1.8 million– 12 million served per center

  5. Poison Center Staffing Medical direction MDs: fellowship-trained medical toxicologists, certified in Medical Toxicology Always have a medical toxicologist available for consultation Management Center managers also fellowship trained in medical/ clinical toxicology, usually PharmDs

  6. Poison Center Staffing 2 Calls handled by specially trained staff From RN, Pharmacist, or MD background Utilize central databases about product ingredients and their toxicology to make triage recommendations Offer additional information to healthcare providers regarding management of individual patients, via telephone Offer telephone consultation with medical toxicologist on call

  7. Poison Center Funding Mixture of state funding, local institutional support, Federal funding For most centers, state funding is the predominant source of funds Federal funding occurs under the Poison Center Support, Enhancement, and Awareness Act of 2008

  8. Southeast (EPA Region 4) Centers AL – 2 centers (Birmingham, Tuscaloosa) FL – 1 system of 3 centers tightly networked together (Jacksonville, Miami, Tampa) GA- 1 center (Atlanta) KY- 1 center (Louisville) MS- 1 center (Jackson) NC- 1 center (Charlotte) SC- 1 center (Columbia) TN- 1 center (Nashville)

  9. Georgia Poison Center 2009 statistics 83,719 human exposure calls (26% from healthcare professionals) 7,866 animal exposure calls 24,084 calls for information about drugs or chemicals 2009 staffing 22.5 FTE of Specialists in Poison Information 1.4 FTE MD medical toxicology 2 FTE PharmD clinical toxicology/ management 3 FTE IT support 5 FTE administrative support 2 FTE health education

  10. Georgia Poison Center 2 Operated by Grady Health System under contract to State of Georgia Training venue for medical and pharmacy students, resident physicians Training fellows in medical toxicologists (joint program with CDC) Provides healthcare hotline for influenza concerns Provides hotline for public health concerns when county health dept is closed Provides antidote location service to connect those needing antidotes with those having the antidote

  11. GPC Operations Center

  12. Call System Status Display

  13. Data System Tracking Display

  14. Resource Staff Display

  15. Georgia Poison Center- relevant recent activities Chempack exercises- GA Radex ’08 Biolab fire 2004 Graniteville, SC train derailment 2005

  16. Why this discussion now? RRT serving Texas has had demonstration project for the past several years, working jointly with their poison centers Offer information to concerned individuals about their risk or management of their symptoms after release of chemicals Favorable report of their project last year led to interest on the part of SE poison center leaders about instituting a similar project in our region

  17. Some Potential Interactions Chemical releases RRT staff informs appropriate poison center(s) about substances released Specific Poison Center telephone number offered through media as number to call for people concerned about health effects Poison center tracks cases, has list of individual callers for back-tracking if needed Joint exercises Use of poison center toxicologists to improve exercise scenario medical effects

  18. Next Steps Decision from attendees about whether this is worth exploring further If so, how should we do this? Possibility of holding a meeting between regional poison center leaders and RRT leaders in Atlanta this summer to develop this relationship

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