Poison information center

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

 

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