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Chapter: Modern Medical Toxicology: General Principles: Introduction

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Poison Control Centres

Arising out of a growing concern over the rising incidence of poisoning worldwide, coupled with a lack of public awareness about its seriousness, Poisons Information Services made their first appearance in the Netherlands in 1949.

POISON CONTROL CENTRES

Arising out of a growing concern over the rising incidence of poisoning worldwide, coupled with a lack of public awareness about its seriousness, Poisons Information Services made their first appearance in the Netherlands in 1949. In 1961, a telephone answering service was introduced in Leeds, Principles England, which gave information to medical practitioners and  others about the poisonous properties of a variety of household, agricultural, and therapeutic substances. On 2 September General 1963, a National Poisons Information Service was established  at Guy’s Hospital, London. The same year, the Illinois C hapter  of the American Academy of Pediatrics opened an Information Centre in Chicago, USA. Since then, all around the world similar Centres have sprung up, performing the invaluable functions of generating public awareness on poisoning, and imparting much needed toxicological diagnostic and therapeutic assistance to doctors.

India made a belated foray with the establishment of the National Poisons Information Centre at the All IndiaInstitute of Medical Sciences, New Delhi in December, 1994.A second Centre was subsequently opened at the NationalInstitute of Occupational Health, Ahmedabad. Some moreRegional Centres have come up in cities such as Chennai, and efforts are under way to establish similar Centres in other parts of the country. The author has established a full-fledged Centre at Cochin (in Amrita Institute of Medical Sciences, a multispecialty teaching hospital) with poison information and analytical services. The Centre subscribes to POISINDEX, while the WHO has provided INTOX free of cost. An Analytical Laboratory attached to the Centre tests for common poisons or drugs in body fluids, as well as in water and medicinal preparations, and other commercial products.

Poison Centres provide immediate, round the clock toxicity assessment and treatment recommendation over the telephone for all kinds of poisoning situations affecting people of all ages, including ingestion of household prod-ucts, overdose of therapeutic medication, illegal foreign and veterinary drugs, chemical exposures on the job or elsewhere, hazardous material spills, bites of snakes, spiders and other venomous creatures, and plant and mushroom poisoning. When a call about a poisoning is received, the poison information specialist obtains a history from the caller, assesses the severity of the poisoning, providestreatment recommendations, and refers the patient for further medical attention when necessary. Referrals to health care facilities when made are later followed up with phone calls to assess progress, and provide additional recommendations until any medical problems related to the poisoning are resolved. Information from the beginning of the call to the final outcome are noted on preformatted case sheets, and quantifiable data is filled in by darkening respective bubbles on the sheet. The data generated is periodically analysed by the Centre and is also monitored for quality assurance of the information specialists. upto 75% of poisonings reported to Poison Centres are managed entirely by telephone consul-tations without further necessity of additional costs for the health care system.


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