Scott A Bier1, Douglas J Borys. 1. Emergency Medicine, C.R. Darnall Army Medical Center, Fort Hood, TX 76544, USA. scottbier@aol.com
Abstract
INTRODUCTION: Every year, emergency medical services (EMS) providers respond to thousands of calls for toxic ingestions. Many systems have begun using poison control centers (PCCs) when unsure of disposition. We sought to determine the type of exposures EMS personnel were using the PCCs for and treatments suggested. Secondary end points included transport rate after consulting the PCC and amount of money saved by avoiding unnecessary transports. METHODS: This study was a qualitative retrospective chart review. Encounters between 2004 and 2006 originating in Austin, TX, were queried and limited to accidental ingestion calls placed by prehospital personnel. Data from charts were then analyzed. RESULTS: A total of 386 charts met inclusion criteria for this study. Household chemicals were the most frequently encountered agents. The most common recommendation was to observe patients at home for the development of concerning symptoms. In only 6% of cases did the PCC recommend administration of medication. Also of interest was the fact that only 63 patients were transported (16%). CONCLUSIONS: It is unreasonable to expect prehospital providers to know what to do for every toxic exposure. This study suggests that the use of PCCs by EMS systems can be beneficial to patient care. For the time period of this study, EMS crews who contacted the PCC saved the City of Austin more than $205,000 in unnecessary ambulance transport costs. When emergency department expenses are factored in and other regions of the country are included, the savings would likely be much greater. This modality is an important resource for providers in a potentially uncertain realm. Published by Elsevier Inc.
INTRODUCTION: Every year, emergency medical services (EMS) providers respond to thousands of calls for toxic ingestions. Many systems have begun using poison control centers (PCCs) when unsure of disposition. We sought to determine the type of exposures EMS personnel were using the PCCs for and treatments suggested. Secondary end points included transport rate after consulting the PCC and amount of money saved by avoiding unnecessary transports. METHODS: This study was a qualitative retrospective chart review. Encounters between 2004 and 2006 originating in Austin, TX, were queried and limited to accidental ingestion calls placed by prehospital personnel. Data from charts were then analyzed. RESULTS: A total of 386 charts met inclusion criteria for this study. Household chemicals were the most frequently encountered agents. The most common recommendation was to observe patients at home for the development of concerning symptoms. In only 6% of cases did the PCC recommend administration of medication. Also of interest was the fact that only 63 patients were transported (16%). CONCLUSIONS: It is unreasonable to expect prehospital providers to know what to do for every toxic exposure. This study suggests that the use of PCCs by EMS systems can be beneficial to patient care. For the time period of this study, EMS crews who contacted the PCC saved the City of Austin more than $205,000 in unnecessary ambulance transport costs. When emergency department expenses are factored in and other regions of the country are included, the savings would likely be much greater. This modality is an important resource for providers in a potentially uncertain realm. Published by Elsevier Inc.