Regional poison centers are staffed by highly trained and certified health professionals who are assisted by extensive information systems. Support is provided by 24-hour access to board-certified medical toxicologists and consultants from diverse medical disciplines, the natural sciences, and industry. The American poison center (PC) is charged with maintaining a database, providing information to the public and to health professionals, collecting epidemiologic data on the incidence and severity of poisoning, preventing unnecessary hospitalizations following exposure, and educating healthcare professionals on the diagnosis and treatment of poisoning. This chapter explores some of the critical roles of poison centers and attempts to offer a vision of the future. Unique issues facing poison centers in other countries are discussed in Chap. 136.
In 1950, the American Academy of Pediatrics (AAP) created a Committee on Accident Prevention to explore methods to reduce injuries in young children. A subsequent survey by that committee demonstrated that injuries resulting from unintentional poisoning were a significant cause of childhood morbidity. Simultaneously came the realizations that a source of reliable information on the active ingredients of common household xenobiotics was lacking and that there were few accepted methods for treating poisoned patients. In response to this void, the first PC was created in Chicago in 1953.72 Although initially designed to provide information to healthcare providers, both the popularity and the success of this center stimulated a PC movement, which rapidly spread across the country. The myriad of new PCs not only offered product content information to healthcare providers, but also began to offer first aid and prevention information to members of the community.
In the 60 years that have since passed, countless achievements have been realized by a relatively small group of remarkably altruistic individuals. Throughout this time, poison services have remained free to the public, highlighting their essential role in the American public health system. Many of the legislative and educational accomplishments, which are chronicled in Chap. 1, have directly reduced the incidence and severity of poisoning in children.69,77,82 Concurrently, the number, configuration, and specific role of PCs has shifted in response to public and professional needs.32,90 However, a crucial test of the utility of modern PCs will be their ability help reverse the US current trend of increased adult mortality from poisoning.16 Additional metrics, such as ICU admissions, length of stay in hospitals, and total healthcare expenditures might serve as other indicators of PC success. The basic functions of PCs are discussed in the following sections.
The first toxicology database created in the United States was a set of cumbersome 5″ × 8″ index cards produced in the 1950s by the US National Clearinghouse of Poison Control Centers.72 When it grew to include more than 16,000 cards, the sheer volume of space required to store this information, and the extensive time necessary to manually search these cards created the necessity of a central repository, such ...