Poison
information center
Content
•
Importance
of having a PIC and its various functions
•
Organization
of a PIC
Objective:
After completion of this lecture, student will be able
to:
• Describe
the importance of having a PIC and its various functions
• Describe
the organization of a PIC
Definition
• Provision
of information regarding the identification and treatment aspects related to
poisoning with any compound
Reason for establishing PIC
• To
end accidental poisoning deaths in children
• To
provide rapid access to information valuable in assessing & treating the
poisoning
• To
assist with poison prevention
Functions
• Assess
and make treatment recommendations during poisonings
• Provide
public and professional educational programs
• Collect
& analyze the data on poisoning
• Perform
research
• Assist
public and healthcare providers during hazardous material spills
Differences between DIC & PIC
a) Clientele
DIC — HCP (only
10% from public)
PIC — Public
(88%)
b) Call volume
DIC — < 7
calls /day
PIC — 103 calls/day/regional
center (range: 33 to 213)
c) Administration
difference
i)
Hours of operation
DIC: 9 AM to 5 PM on weekdays
PIC: 24 hours a day year round
ii) Cost
DIC: Less expensive
PIC: More expensive
iii) Staffing
DIC: Pharmacist, Less number
PIC: Pharmacist / Physician / Nurse, More number
iv) Funding
DIC: Sponsoring
hospital/medical centre
PIC: Public/
industry contacts / organized donation program
d) Procedural
difference
i) Response time
DIC: Average 15 to
30 minutes (may extend to days)
PIC: Immediate
response (average time –5 minutes)
ii) Call complexity
DIC: More complex
PIC: Less complex
iii) References
DIC: Less number of references
PIC: More number of references
iv) Documentation (DIC & PIC)
• General
epidemiological data (date, time & reason)
• Caller
characteristics (site and place)
• Patient
characteristics (age, sex, pregnancy)
• Exposure
characteristics (substance, route and site of exposure)
• Clinical
course (clinical status, medication given)
• Medical
management (therapeutic intervention)
Organization of PIC
In organizing a PIC, consider “ideal human exposure call
volume” anticipated
a)
Personnel
• Is
important element of PIC
• Needs
unique qualifications and training
• Has
distinct responsibilities
i) Medical director
• Responsible for all medical aspects of
PIC’s operation
• Regular
review of and authorization of all poisoning management protocols
• Authorization
of poison center polices and procedures
• Participation
in staff training
• Provision of an-call clinical support for PIC
staff
• Participation in quality assurance activities
• Liaison
with local medical societies, physicians
• Promotion of research
• Co-ordination of professional educational
efforts
ii) Manager/supervisor
• Pharmacist/
physician/ nurse with training in the area of clinical toxicology
Duties:
• Budgeting
• Purchasing
• Staffing
schedule
• Staff
supervision
• Staff
training
• Maintenance
of continuous quality improvement program
• Development
of departmental policies/ procedures
• Preparation
of administrative reports
• Media
response
• Professional
education
• Co-ordination
of program with the sponsoring entities
iii) Poison information specialists
• Backbone
of PIC
• Directly
interact with HCP and patients
• PI
specialist must be both clinicians and counselors
• Pharmacist
/ nurse are suitable
Duties:
-Elicit complete history
-Assess correctly the severity of exposure
-Provides management plan
-Proper communication
-Follow up
iv) Public Education Co-ordinator
• To
reduce the incidence of accidental poisoning in their service areas by teaching
/educating public how to prevent poisonings
• Should
have a background in education and media communication and experience as PI
specialist
Duties:
• Development,
distribution and evaluation of poison prevention programs and materials
• Co-ordination
of regularly occurring public education messages through the media
• Networking
with schools and other organizations to provide cost-effective public education
• Co-ordination
of poison prevention through poison information specialist
v) Other personnel
• Secretarial
staff
• Volunteer
• Postdoctoral
fellowship
• Attender
(b) Facility
consideration
i) Location
» Can
be anywhere (but there should be access to telephone)
» Ideal
location is adjacent to emergency department
» Other
locations include library, pharmacy & schools of pharmacy
ii) Space
• 100
to 200 square feet/ workstation
• Room
for director / supervisor – should be adjacent to work place
• Rest
room
• Proper
ventilation, lighting, aeration & furniture etc
(c) Equipment’s
• Telephone
system – enough incoming lines (3 way calling)
• Computers
• Fax
machine, Internet, filing cabinets
• Refrigerator
(if not located near cafeteria)
• Shelving
to store articles and books
• UPS/
generator
(d) Resources
• Primary
• Secondary
• Tertiary
• Online data
(e) Policies and
Procedures
• It
may vary from center to center
• Method
of operation
• Position
of each persons and responsibilities
(f) Training of PI
specialists
Centre should provide training to staff in the following
area
(i) Clinical
toxicology
(ii)
Communication
(iii) Information retrieval
(iv) Data collection/coding
(v) Critical thinking
(vi) Handling of telephone and other
equipments
Performance evaluation
Staff
• Knowledge
• Skills
• Retrieval
• Communication
Quality Improvement Program
• To
assess the level of performance of PIC
• To meet the demands of the need of the public/
health care providers
• If
the demands are not met ,Centre should develop:
-Strategies and policies,
-Implement and re- assess in order
to promote or increase the level of performance
Summary
• Provision
of information regarding the identification and treatment aspects related to
poisoning with any compound
• Functions
of PIC
• Difference
between PIC AND DIC
• Organization
of PIC
• Quality
improvement programs
