By Cyrus Rangan, MD, FAAP, FACMT
Assistant Medical Director of the California Poison Control System and Medical Toxicologist for Children’s Hospital Los Angeles, Dr. Cyrus Rangan has spoken for Symposia Medicus since 2015. Amidst the rise in telehealth during the COVID-19 pandemic, Dr. Rangan reminds us of the vital role that Poison Control Centers can play in the management of patients, particularly as one of the pioneer telehealth services in the U.S.
The coronavirus pandemic has significantly altered the way we deliver medical care, from regular use of industrial-grade PPE in our hospitals to handling entire outpatient medical encounters via online video platforms. Back in 1953, pharmacist Luis Gdalman established the first nationally recognized Poison Control Center at Presbyterian-St. Luke’s Medical Center in Chicago, Illinois. It was a national effort to establish an extensive library on the management of acute and chronic poisonings, and began a national public safety campaign to reduce the number of poisonings in children, which had reached 400 children per year at the time. Today, 55 Poison Control Centers offer this long-standing telehealth medical service in the United States, employing more than 1,700 professionals who advance poison information, advocacy, education, and research. But most importantly, they provide direct medical advice to families at home and to healthcare providers when a victim encounters a poison.
When you call the Poison Control Center at 1-800-222-1222, you are routed to your accredited regional poison center. Calls from medical providers are generally handled by a Certified Specialist in Poison Information (CSPI). These specialists are usually pharmacists, nurses, or other skilled health professionals who have undergone extensive training and are certified as a CSPI by way of a rigorous examination. The CSPI serves as a one-on-one telehealth medical consultant for your case. You will have the opportunity to speak directly about your patient in a fully HIPPA-compliant encounter. The CSPI records your patient’s data in a confidential medical record, and then offers the most current evidence-based advice for you and your patient, which may include diagnostic work-up of unknown poisons, guidelines for supportive care, pertinent laboratory studies, and antidotal treatments. The team of CSPIs at your center typically call you or your center back at regular intervals to monitor patient progress and offer additional advice as appropriate.
Poison Control centers offer up-to-the-minute expert advice on the care of your patients, prevent non-fatal poisonings and poisoning deaths, help conserve resources at your health center, and minimize the time that your patient needs to spend in the healthcare setting. Sometimes you may have a patient with a complex condition that may require a higher level of consultation. At any time, you are welcomed to ask to speak to the Medical Toxicologist on-call to discuss complex patients.
All Poison Control Centers are equipped to handle any call regarding a toxic exposure. At the California Poison Control System (CPCS), we operate the largest single provider of poison control services in the United States and are the primary resource for poison education, prevention, and treatment for California’s general public and health care professionals. We field almost 300,000 calls per year, while saving Californians millions of dollars in unnecessary healthcare costs. In fact, for every $1 spent on Poison Control Services, we save $7 in unnecessary healthcare costs. Our Health Education Program develops and implements innovative materials and programs to prevent poisonings and raise awareness of CPCS and its services.
Poison Control Centers respond to a wide variety of potentially poisonous exposures, including:
- Over-the-counter and prescription medications
- Illegal drugs
- Carbon monoxide
- Acids, bases, solvents, antifreeze, cleaning products, and other “garage chemicals”
- Lead, mercury, arsenic, and other heavy metals
- Radiation exposures, chemical spills, pesticides, and other hazardous materials
- Plants and mushrooms
- Envenomations by venomous creatures including rattlesnakes, coral snakes, marine creatures, spiders, bees, ants, and scorpions
- Real-time detection and surveillance for emergent health events such as coronavirus, pandemic flu, and during chemical, biological, radiological, nuclear, and explosive threats
Your patients and families may call the Poison Control Center at any time for advice on known or possible exposures in the home. Most poisonings occur in the home, with over 60% occurring in young children. The Poison Center is successful in helping the overwhelming majority of families avoid a visit to the emergency department. In the event that a victim needs care, Poison Control Centers are equipped to advise on patient transportation to the emergency department or to coordinate with emergency medical services to provide optimal care to your patient who calls us from home.
Poison Control is a 24/7/365 service that is free to call for any reason related to human exposures to toxic substances. Poison Control centers are funded primarily by a combination of state and federal budget allocations and by a few grants.
Further Resources:
Want to learn more about poisons?
Visit our website at https://calpoison.org/.
For an interactive educational experience, try our online game: Pills vs. Candy
California Poison Control PSA Videos:
Dr. Rangan is Assistant Medical Director of the California Poison Control System and Medical Toxicologist for Children’s Hospital Los Angeles. He lives in La Crescenta, California.