Emergency Medical Services
The Maryland Poison Center is designated by the Maryland Institute for Emergency Medical Services Systems (MIEMSS) as a specialty referral center for EMS providers in Maryland. Pharmacists and nurses who are nationally certified as Specialists in Poison Information staff the poison center 24/7. In 2019, the specialists managed 36,254 cases, with more than 1,700 from EMS providers!
Photo courtesy of MIEMSS.
The Maryland Poison Center is a valuable resource for medical consultations, and poison center staff can give the best treatment advice for each patient. Our professionals follow that patient through their hospital stay, continuing to make treatment recommendations. Patients managed with poison center expertise on average experience shorter hospitalizations (median length of stay of two days versus five days without poison center assistance), helping health care providers serve more patients and decrease healthcare costs (J Toxicol Environ Health Part A. 2007; 70(2): 107-110). Records are kept on outcomes and treatments for each patient. This information allows us to continually assess the effects of drugs, chemicals, and poison treatments.
What information can the poison center provide to EMS providers?
- Assessment of poisonings, overdoses, and envenomations
- Range of toxicity (toxic dose information)
- Overdose and poisoning signs and symptoms
- Toxidrome identification
- Specific treatment recommendations for each patient
- Decontamination recommendations
- Assistance in locating antidotes and antivenom
- Drug interactions
- Pill identification
- Identification of chemicals that may be hazardous to first responders and providers
- Access to public health emergency information (i.e., food recalls, terrorism)
In addition to the above, the poison specialists can determine whether EMS transport is needed. In many cases, patient and/or provider consultation with the poison center through 911 can avoid a trip to the hospital saving health care resources. When EMS providers or 911 consulted with the MPC about patients in 2018, 9 percent of those patients were not taken to a health care facility based on poison center advice. Moreover, 65% of all MPC cases were managed outside of a health care facility with poison center advice. A report by the Lewin Group, released in 2012 by the American Association of Poison Control Centers, estimated that every dollar invested in the poison center system saves $13.39 in medical costs and lost productivity, for a total savings of more than $1.8 billion every year.
Can EMS providers share patient information with the poison center?
Absolutely! Poison centers fall under "covered entities" in the HIPAA Privacy Rule regulations. (45 CFR 164.501, 506(c)) and are considered part of the health care team. Calls and patient information are kept confidential, and poison centers are held to the same HIPAA requirements that other health care providers abide by.
What happens to the information I give to the poison center?
All of our cases are entered into a data collection system as the call is taken. The data we gather is encoded and shared nationally through the National Poison Data System (NPDS), a data collection system that is administered by the American Association of Poison Control Centers (AAPCC). Calls to all U.S. poison centers are uploaded and analyzed every eight minutes to detect trends and events that might be of public health significance (e.g., food poisoning, environmental hazards, product recalls, and terrorism). NPDS is the only near real-time comprehensive poisoning surveillance database in the United States. Data from U.S. poison centers have also been used to help pass federal, state and local laws and regulations for synthetic drugs of abuse, liquid nicotine, laundry detergent packets and more.
What other services does the Maryland Poison Center offer to EMS providers?
The staff of the Maryland Poison Center is actively involved in the training of EMS providers through classes, drills, continuing education presentations, and onsite training opportunities at the poison center.
Additionally, the Maryland Poison Center publishes ToxTidbits, a monthly e-newsletter for health professionals. Topics include the toxicity of specific poisons and drugs, antidote use, drug abuse trends, and more. To sign up to receive ToxTidbits and for more information on health professional education, go to our website: www.mdpoison.com/healthcareprofessionals. Get up-to-date toxicology news and information by following the Maryland Poison Center on Twitter at @MPCToxtidbits.
How can EMS providers help the Maryland Poison Center?
Consulting with a poison center on all poisonings helps us to identify public health threats such as terrorism, new drugs of abuse, and food poisoning. In addition, we analyze and research cases that we've been consulted on to determine the effectiveness of treatments and to identify where our public education efforts are needed.
EMS providers can help us help the public. Educational materials such as brochures, telephone stickers, magnets, and posters are available from the Maryland Poison Center for school visits, health fairs, open houses and safety days. By promoting the Maryland Poison Center, you can help prevent poisonings, ensure your patients will get the help they need right away if a poisoning occurs, and save them time and money by avoiding unnecessary use of EMS and emergency department services. Calling the poison center also provides you piece of mind that they are speaking to health care providers who are experts in managing poisonings or overdoses, allowing you to focus on patients who need your help most.