History Functions of PCC PCC Certification Poison center case management Comparison between PCC and...

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Transcript of History Functions of PCC PCC Certification Poison center case management Comparison between PCC and...

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Slide 2 History Functions of PCC PCC Certification Poison center case management Comparison between PCC and DIC Considerations of PCC Slide 3 1953 The establishment of the First PCC 1958Formation of American Association of Poison Control Centers (AAPCC) 1978661 poison centers in the USA 2000A single nationwide toll-free telephone number providing access to poison centers in all 50 US states Slide 4 PCCs are established for two reasons: To provide rapid access to information valuable in assessing and treating poisonings To assist with poisoning prevention Slide 5 Assessment and treatment recommendations for poisoning via 24-hour emergency telephone services Providing public and professional educational programs Collecting data on poisonings for research Training healthcare professionals Assisting the public and health care providers during hazardous material spills Slide 6 AAPCC provides a program that certifies regional poison centers Criteria for Certification: o Demonstration that the center is used appropriately throughout the region o Adequate staffing by specialists o Demonstration of the role of the physician Slide 7 Criteria for Certification- Contd: Medical director in the operation of the center Adequate training and experience of an administrative director Demonstration of adequate programs in professional and public education Participation in the AAPCC data collection Slide 8 1. Receiving the call 2. Assessing history of exposure & potential for development of toxicity 3. Making a decision regarding the most appropriate location for continued care of the patient 4. Providing additional recommendations for patient management (observation, dilution, irrigation, emesis induction) Slide 9 5. Completing routine follow-up to monitor patient status (if observation/decontamination is recommended) 6. If expected response to home treatment does not occur, recommend transporting to ER 7. Informing the ER staff of patients status & providing initial recommendations for care Slide 10 8. Providing toxicology consultations in the hospital (bedside or by telephone) 9. Documenting all poison center interventions Slide 11 Both have a common goal provide comprehensive, accurate, and timely information to their clients Both use the information to enhance the medical care of patients Both have similar information retrieval process and physical layouts Despite these similarities, there are a number of important differences between the two services Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 12 Clientele : Public vs. health care professionals 88% of PCC calls came from public 9-10% of DIC calls came from public Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 13 Call Volume : Extremely large from public versus health care professionals Average is 103 calls per day (human exposure only) Range is 33 to 213 calls per day Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 14 Hours of Operation/Cost : PCC operates 24 hrs a day year-round vs. 9 AM to 5 PM PCC requires large staffs compared to DIC PCC is more expensive to operate than DIC Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 15 Staffing : PCC relies not only on pharmacist but also on other health care professionals with specialized training/certification (nurses, physicians, technicians) Nurses worked 52% of the total phone hours in 1993 Pharmacists and physicians worked 36% and 3% of the total hours, respectively Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 16 Response Time : All PCC calls require an immediate response Time is related to the efficacy of the therapeutic interventions The average response time is 5 min in PCC vs. 15 - 30 min in DIC Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 17 Call complexity : PCC calls are less complex than DIC calls Most poisoning patients rarely have complex medical history Poisoning agents re-occur constantly from year-to-year PCC is the first point of contact by public and health professionals Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 18 References: PCC assess and make treatment recommendation for any potential poison (medication, chemical, household, biological, natural toxin), But DIC handle medication and pharmacy-related inquiries PCC will often have a broader base reference collection than DIC Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 19 Documentation: Documentation helps in developing a data system General Epidemiological Data (date & time of call, reason for exposure) Caller characteristics (site of call) Patient characteristics (age, gender, pregnancy status) Exposure characteristics (substance, route and site of exposure) Clinical course (clinical manifestation, medical outcomes) Medical management characteristics(therapeutic intervention) Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 20 Medical director Physician with fellowship/certification in medical toxicology Duties include Protocol review and approval Audit of poison center recommendations Availability for consultation on difficult cases Administrative director Slide 21 5-6 full time Specialists in Poison Information (SPIs) with specialized training: Pharmacists Nurses Qualifications AAPCC offers a certification examination for SPIs who: Worked at least 2000 hours in a poison center Managed at least 2000 cases Public education coordinator Slide 22 Facility considerations : Location (near ER, medical library, hospital pharmacy) Work space and environment Equipment : Telephone system (direct with enough lines) PC computer system and/or local area network (LAN) Modem and facsimile machine Internet access Other (such as file cabinets, refrigerators) Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 23 Resources : Two factors should be available in PCC The experience and training of the specialist The quality of the information available to the specialist Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 24 Resources : Micromedexs Poisindex (a database of more than 800,000 household products, chemicals, and medications) Clinical Toxicology of Commercial Products General clinical toxicology texts Specialized toxicology texts Internal protocol for handling certain poisons Primary literature (case report) On-call medical support and experts in the area Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 25 Policy and Procedures : Different than DIC in almost all aspects Can include: Handling intentional exposure Long term public education program Release of PCC tape recording Telephone system repair Yousif Abdu Asiri, The Difference Between Drug Information Center (DIC) and Poison Control Center (PCC).Power Point Presentation Slide 26 PCCs and DICs may have similar goals but differ considerably in functions, clientele, staffing and type of calls PCC may be combined with DIC as a Drug and Poison Information Center (DPIC) Appropriate utilization of PCC is associated with huge costs savings