Drug Identification: A Survey of Poison Control Centers

ArticleinJournal of toxicology. Clinical toxicology 42(4):371-81 · February 2004with12 Reads
DOI: 10.1081/CLT-120039543 · Source: PubMed
Abstract
The objective of this study was to determine current practices and opinions of poison center staff and directors regarding drug identification (ID) calls. Surveys were developed and mailed to 911 poison center staff members and 69 managing directors at 69 poison control centers in the United States in December 2001. Responses were received from 317 staff members and 33 directors from 49 centers. Nearly half of the staff respondents stated that they had not received drug ID training beyond how to look up the identity of an oral medication. About one-half of staff and director respondents stated that their centers had only informal (unwritten) drug ID policies, while one-fourth each responded they had formal written policies or had no policy at all. A majority of respondents indicated that their centers either allow or require specialists to provide ID for non-ingestion-related cases. Nearly all staff and director respondents routinely provide ID services to law enforcement officers and health care professionals regardless of whether ingestion was involved. Slightly more than one-half of staff respondents inquire about possible ingestion with almost every request, while one-third only inquire when the caller gives some indication that ingestion may have occurred. Case-based questions reveal that different practices are utilized depending on the type of medication for which ID is being requested. Factors such as risk of liability, patient confidentiality, guardianship, and the person's best interest appear to contribute to decisions regarding the provision of medication ID. Drug identification practices vary from center to center throughout the United States. Though the service is greatly utilized, few centers have written policies. In addition, training for the provision of this service appears to be inadequate in many centers. The development of drug identification guidelines to be utilized throughout poison centers would provide much needed consistency and guidance.
    • "It might be an inevitable result in this study. Since it is impossible to provide direct physical examinations or immediate therapeutic interventions to the poisoned patients by telephones, it is very important to reduce false negatives (3-5, 14). "
    [Show abstract] [Hide abstract] ABSTRACT: The aim of this study was to develop and evaluate a triage method to prevent unnecessary emergency department visits of out-of-hospital poisoned patients. From October 2003 to September 2004, the calls that lay persons gave to the Seoul Emergency Medical Information Center to seek advice on the out-of-hospital poisoned patients were enrolled. We designed a triage protocol that consisted of five factors and applied it to the patients. According to the medical outcomes, we classified the patients into two groups, the toxicity-positive and the toxicity-negative. We arranged the factors on the basis of the priority that was determined in order of the odds ratio of each factor for the toxicity-positive and made a flow chart as a triage method. Then we calculated a sensitivity, specificity, positive predictive value and negative predictive value of the method. We regarded the specificity as the ability of the method and the sensitivity as the safety. A total of 220 patients were enrolled in this study. The method showed a sensitivity, specificity, positive predictive value, and negative predictive value of 99.2%, 53.4%, 76.2%, and 97.9%, respectively. Our triage method prevented 53.4% of the unnecessary emergency department visits of out-of-hospital acutely poisoned patients, safely.
    Full-text · Article · May 2007
  • [Show abstract] [Hide abstract] ABSTRACT: Introduction Texas poison centers identified carisoprodol as a skeletal muscle relaxant that is subject to abuse, and this investigation explores the abuse reported by Texas poison centers. Methods This study used data from six Texas poison centers to describe the epidemiology of carisoprodol abuse and drug identification (ID) calls from 1998 to 2003. Results Drug ID and abuse calls were 217% higher in 2003 than in 1998. Although eastern and central Texas contains 43% of the state’s population, this region reported 77% of all drug ID calls and 64% of abuse calls. Male patients accounted for 51% of abuse calls and 37% of other human exposure calls. Patients from 13 to 19 years of age accounted for 17% of abuse calls and 9% of other human exposure calls. Among those human exposure calls with a known medical outcome, a higher percentage of abuse calls involved minor effects while a greater proportion of other human exposure calls involved outcomes that ranged from moderate effects to death. Conclusions Carisoprodol abuse is increasing in Texas and is substantially more common in the eastern part of the state. Carisoprodol abuse is much more likely, than other types of adverse carisoprodol exposures, to involve males and adolescents; and it less likely to involve adverse medical outcomes.
    Article · Mar 2006
  • [Show abstract] [Hide abstract] ABSTRACT: Texas poison centers identified carisoprodol as a skeletal muscle relaxant that is subject to abuse, and this investigation explores the abuse reported by Texas poison centers. This study used data from six Texas poison centers to describe the epidemiology of carisoprodol abuse and drug identification (ID) calls from 1998 to 2003. Drug ID and abuse calls were 217% higher in 2003 than in 1998. Although eastern and central Texas contains 43% of the state's population, this region reported 77% of all drug ID calls and 64% of abuse calls. For male patients, 51% of the calls were abuse calls and 37% were other human carisoprodol exposure calls. Patients from 13 to 19 years of age accounted for 17% of abuse calls and 9% of other human exposure calls. Among those human exposure calls with a known medical outcome, a higher percentage of abuse calls involved minor effects while a greater proportion of other human exposure calls involved outcomes that ranged from moderate effects to death. Carisoprodol abuse is increasing in Texas and is substantially more common in the eastern part of the state. Carisoprodol abuse is much more likely, than other types of adverse carisoprodol exposures, to involve males and adolescents; and it less likely to involve adverse medical outcomes.
    Article · Apr 2006
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