Poison Control Questions

[PharmDFisher]

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Can anyone give me information about poison control? Like what they do in a normal day? How much they make? What kind of qualifications do you have to have?

 

[Aznfarmerboi]

Can anyone give me information about poison control? Like what they do in a normal day? How much they make? What kind of qualifications do you have to have?

Poison control/drug centers is a speciality of pharmacy and toxicology. On a usual normal day (although I have zero experience in this), it acts as a drug information center. Physcians, other health care providers, firefighters, pramedics, and patients will call to ask for information and what to do to exposure or overdose in drugs, plants, and other chemicals. Furthermore, a professional in a poison control center might attend or host lectures and fairs to educate the public. What they make varies and depends on what level you are involve in (I am guessing the ballpark figure is anywhere from 60-80k starting) and then an increase depending on your years of experience. In terms of qualifications, it varies between states and is up to you to find out. Usually, it involves at least a year of residency including X amounts of logged hours and phone calls under supervision.

 

[PharmDFisher]

Do physicians call poison control to ask treatment procedures on certain things?

 

[DownonthePharm]

You can begin working at a Poison Control center your first year of pharmacy school. Many of my classmates are interning at our center on campus and they do about a month or more of full-time training then begin answering phone calls on their own.


Here is the link to the Oklahoma Poison Control which has a little information about job purpose, accrediation and the like.

http://www.oklahomapoison.org/about/

 

[Hels2007]

Do physicians call poison control to ask treatment procedures on certain things?

Yes. The director of a poison control center is an MD, board-certified in Emergency Medicine and Toxicology. A physician may ask for an over the phone consult or a bedside consult in severe cases.

I have done a monthlong rotation at a poison control center. Ours was staffed with nurses, though, rather than pharmacists, and 3 MDs (one very experienced, and most knowledgeable doctor I have ever met, and two newly certifed in toxicology, but also very very smart). In the morning, I would come and review all hospitalized cases - sometimes there would be 3, sometimes 15 - I would have about an hour to review them, look up all the mechanisms of toxicity of the drugs in question, think what else could be going on. Then the doctors, the chief nurse and I would review the cases, and one of us would then make calls for follow-ups as determined by the MDs. Other than that, time would be spent answering questions. It's an interesting place to work. Sure, sometimes it's slow, sometimes it's crazy busy. Sometimes all you get is pill IDs, sometimes it's something exotic like "a child in my class just ate the bouquet and we think it was poison hemlock!" call from a frantic teacher. I really liked my rotation, though, the people were very nice.

What the pharmacists would make, I don't know, but the nurses made the same as hospital nurses, so I would assume pharmacists would be about the same as hospital pharmacists. As far as qualifications, to work in a certified poison control center (and all but 5 or so in the US are certified) you would have to take a certification exam (specialist in poison information or something like that, the abbreviation is SPI), after spending 2000 hours on the phone. It's only offered once a year in the spring, and you have to retake it every 7 years.

 

[PharmDFisher]

Yes. The director of a poison control center is an MD, board-certified in Emergency Medicine and Toxicology. A physician may ask for an over the phone consult or a bedside consult in severe cases.

I have done a monthlong rotation at a poison control center. Ours was staffed with nurses, though, rather than pharmacists, and 3 MDs (one very experienced, and most knowledgeable doctor I have ever met, and two newly certifed in toxicology, but also very very smart). In the morning, I would come and review all hospitalized cases - sometimes there would be 3, sometimes 15 - I would have about an hour to review them, look up all the mechanisms of toxicity of the drugs in question, think what else could be going on. Then the doctors, the chief nurse and I would review the cases, and one of us would then make calls for follow-ups as determined by the MDs. Other than that, time would be spent answering questions. It's an interesting place to work. Sure, sometimes it's slow, sometimes it's crazy busy. Sometimes all you get is pill IDs, sometimes it's something exotic like "a child in my class just ate the bouquet and we think it was poison hemlock!" call from a frantic teacher. I really liked my rotation, though, the people were very nice.

What the pharmacists would make, I don't know, but the nurses made the same as hospital nurses, so I would assume pharmacists would be about the same as hospital pharmacists. As far as qualifications, to work in a certified poison control center (and all but 5 or so in the US are certified) you would have to take a certification exam (specialist in poison information or something like that, the abbreviation is SPI), after spending 2000 hours on the phone. It's only offered once a year in the spring, and you have to retake it every 7 years.

Ok your saying that there is a MD coordinator, which I'm sure he's not there 24 hours a day. So if I were to be working in a center (as a pharmd) and a doctor called saying that he thinks a patient ate flowers or what ever, am I allowed to advise him in whats best course of treatment, ie drink milk or take this drug because it will neutralize or what not, or can only the MD give that advice.

Sorry for taking peoples time, just don't want to start picking a career path that would or wouldn't interest me.

 

[Hels2007]

Ok your saying that there is a MD coordinator, which I'm sure he's not there 24 hours a day. So if I were to be working in a center (as a pharmd) and a doctor called saying that he thinks a patient ate flowers or what ever, am I allowed to advise him in whats best course of treatment, ie drink milk or take this drug because it will neutralize or what not, or can only the MD give that advice.

Of course. You would advise on the initial management. Very, very small percentage of calls gets referred to the MDs. However, MDs are always available to be paged, any time of day or night, if the caller insists on speaking to one. Callers are rarely physicians, btw, only in very serious cases, usually it's nurses if it is from healthcare, but vast majority of calls are parents/friends/family/ or poisoning victims (term used loosely) themselves, calling from home/school/wherever in the community something happened.

 

[PharmDFisher]

Of course. You would advise on the initial management. Very, very small percentage of calls gets referred to the MDs. However, MDs are always available to be paged, any time of day or night, if the caller insists on speaking to one. Callers are rarely physicians, btw, only in very serious cases, usually it's nurses if it is from healthcare, but vast majority of calls are parents/friends/family/ or poisoning victims (term used loosely) themselves, calling from home/school/wherever in the community something happened.

Thats where I don't understand the system here, because if I were a parent of a kid who just swallowed something poisonous or got bit by a snake, theres no way in hell i would call poison control. I mean if you do something that you think is a danger do to poisoning I would bring/go strait to an ER or doctors office. I mean someone over the phone can tell you to drink milk or induce vomiting or what not, but the doctor can do it themselves. So why wouldn't the doctor or medical staff be calling poison control.

 

[Hels2007]

Thats where I don't understand the system here, because if I were a parent of a kid who just swallowed something poisonous or got bit by a snake, theres no way in hell i would call poison control. I mean if you do something that you think is a danger do to poisoning I would bring/go strait to an ER or doctors office. I mean someone over the phone can tell you to drink milk or induce vomiting or what not, but the doctor can do it themselves. So why wouldn't the doctor or medical staff be calling poison control.

That's because you don't understand what "poison patient" means. 90% of the calls are "my kid just liked the lid of the detergent bottle" or "my four year old just swallowed one of my Tylenols" or "she just rubbed some degreaser all over her arms" - cases which are absolutely non-dangerous, and taking child to the ER is an unnecessary waste of healthcare dollars (which will ultimately come out of your pocket! if you haven't been hit with rising premiums already...) and unnecessary stress to the child. Then there are some cases that get referred - such as a snake bite (but in this case you would be very much a fool if you don't call Poison Control first - do you think every hospital has stores of antivenom? Only a few do, and Poison Center will either refer you where it is available, or arrange for it to be delivered, or for you to be taken to the hospital, by helicopter if necessary). In any case where medical attention is warranted (unknown substance or unknown amount swallowed, any intentional overdose/multidrug overdose, any loss of consciousness, etc.) Poison Control gives the information to the ER, so they know they are coming, what the problem was, etc. Most people don't have brain enough to bring the bottle of the stuff which is the reason for the problem, at least if they call from home, it is still within reach.

As far as the cases for which a doctor calls... Of course no doctor will call for a trivial case, but for example, you have a patient with unknown multidrug overdose (dropped off by a friend, unconscious, no history available). You do an EKG and see that their QRS is elevated. Then you may want to call poison control center to ask opinion of whether it is drug-related, what are most likely causes, and what is the best management. Or whether to start NAC in a borderline case of APAP overdose. There are some cases that require attention of a board-certified medical toxicologist (and they aren't common, there are about 300 in the entire US).

 

[PharmDFisher]

That's because you don't understand what "poison patient" means. 90% of the calls are "my kid just liked the lid of the detergent bottle" or "my four year old just swallowed one of my Tylenols" or "she just rubbed some degreaser all over her arms" - cases which are absolutely non-dangerous, and taking child to the ER is an unnecessary waste of healthcare dollars (which will ultimately come out of your pocket! if you haven't been hit with rising premiums already...) and unnecessary stress to the child. Then there are some cases that get referred - such as a snake bite (but in this case you would be very much a fool if you don't call Poison Control first - do you think every hospital has stores of antivenom? Only a few do, and Poison Center will either refer you where it is available, or arrange for it to be delivered, or for you to be taken to the hospital, by helicopter if necessary). In any case where medical attention is warranted (unknown substance or unknown amount swallowed, any intentional overdose/multidrug overdose, any loss of consciousness, etc.) Poison Control gives the information to the ER, so they know they are coming, what the problem was, etc. Most people don't have brain enough to bring the bottle of the stuff which is the reason for the problem, at least if they call from home, it is still within reach.

As far as the cases for which a doctor calls... Of course no doctor will call for a trivial case, but for example, you have a patient with unknown multidrug overdose (dropped off by a friend, unconscious, no history available). You do an EKG and see that their QRS is elevated. Then you may want to call poison control center to ask opinion of whether it is drug-related, what are most likely causes, and what is the best management. Or whether to start NAC in a borderline case of APAP overdose. There are some cases that require attention of a board-certified medical toxicologist (and they aren't common, there are about 300 in the entire US).

Ok, don't know too many parents who would call poison control if they licked deodorant or swallowed a aspirin, but in the case of a snake biting your kid you call 911, and the ambulance service would bring them to the nearest Er and from there it would be the hospitals assessment to whether or not to transfer the kid to another hospital or to get anti venom from another hospital. Most parents wouldn't take two thoughts of calling poison control, they would 1 either call 911 or 2 rush them to the doctors themselves.