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The Illinois Poison Center And Public Health Emergency


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The role of a poison center in a public health emergency

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The Illinois Poison Center And Public Health Emergency

  1. 1. The Illinois Poison Center and Public Health Emergencies The Role of a Poison Center in Preparedness and Response
  2. 2. Outline <ul><li>Introduction to the Illinois Poison Center </li></ul><ul><li>Surveillance and Reporting </li></ul><ul><li>Education </li></ul><ul><li>Information </li></ul><ul><li>Call center services and surge capacity </li></ul>
  3. 3. Introduction to IPC <ul><li>Program of Metropolitan Chicago Healthcare Council (MCHC) </li></ul>
  4. 4. Mission <ul><li>The Illinois Poison Center is dedicated to reducing the incidence and injury of poisoning in our communities through immediate expert telephone recommendations, innovative public and health care professional education and focused research. </li></ul>
  5. 5. Illinois Poison Center <ul><li>Current Clinical Staffing : </li></ul><ul><li>16 Pharmacists and nurses </li></ul><ul><li>7 Poison information </li></ul><ul><li>providers </li></ul><ul><li>3 Medical directors </li></ul>
  6. 6. Illinois Poison Center <ul><li>Staffed 24/7 </li></ul><ul><li>Over 107,000 calls in 2006 </li></ul><ul><li>Over 15,000 calls from health care providers </li></ul>
  7. 7. Illinois Poison Center <ul><li>Part of the American Association of Poison Control Centers </li></ul><ul><li>Constant contact with other centers </li></ul><ul><ul><li>Trends </li></ul></ul><ul><ul><li>New products and toxicities </li></ul></ul><ul><ul><li>Common Database </li></ul></ul>
  8. 8. Clinical Surveillance <ul><li>Clinical surveillance (or Syndromic Surveillance) refers to the systematic collection, analysis, and interpretation of health data about a clinical syndrome that has a significant impact on public health, which is then used to drive decisions about health policy and health education. </li></ul>
  9. 9. Surveillance <ul><li>Software-driven Surveillance of National Poisoning Database System (NPDS) </li></ul><ul><li>Individual Reporting: High index of suspicion, clinical awareness </li></ul><ul><ul><li>Driven by experience </li></ul></ul>
  10. 10. Software surveillance <ul><li>All exposure calls are logged into an electronic program with two functions </li></ul><ul><li>One function is the medical record: </li></ul><ul><ul><li>Recorded history, physical, assessment and plan </li></ul></ul><ul><li>The second is database </li></ul><ul><ul><li>All products are coded along with any clinical symptoms noted </li></ul></ul>
  11. 11. Software Surveillance <ul><li>The coded fields from every poison center in the U.S, are uploaded every 20 minutes to New Jersey (essentially real-time) </li></ul><ul><li>The data is then analyzed with software developed in conjunction with the CDC (BIOSENSE) </li></ul>
  12. 12. Software Surveillance <ul><li>National Surveillance </li></ul><ul><ul><li>three standard deviations from moving 14 day average for past three years creates a notification </li></ul></ul><ul><ul><li>Total Call Volume (by center) </li></ul></ul><ul><ul><li>Human Exposure Volume (by center) </li></ul></ul><ul><ul><li>Clinical Effects </li></ul></ul><ul><li>Local Surveillance </li></ul><ul><ul><li>Training End of 2007 </li></ul></ul><ul><ul><ul><li>Can set for substances, clinical effects, adjust std dev </li></ul></ul></ul><ul><ul><ul><li>Can set for zip codes </li></ul></ul></ul>
  13. 13. Individual Reporting <ul><li>Public Health Reporting by individuals </li></ul><ul><li>Astute clinician realizes something is out of the ordinary and reports it to other agencies </li></ul><ul><li>Recognition can occur in various points of patient care </li></ul>
  14. 14. Examples of Food Borne Illness Reporting <ul><li>March 2004 </li></ul><ul><li>Call to Illinois Poison Center from HCF re: 2 individual with severe muscle breakdown </li></ul><ul><li>Recent ingestion of Buffalo Fish </li></ul><ul><li>Dx: Haff Disease </li></ul>
  15. 15. Examples of Food Borne Illness Reporting <ul><li>Fall, 2006 </li></ul><ul><li>Call from HCF regarding patient with numbness, tingling and reversal of hot and cold </li></ul><ul><li>Patient recalls eating grouper at restaurant that night </li></ul><ul><li>Dx: Ciguatera Poisoning </li></ul>
  16. 16. Examples of Food Borne Illness Reporting <ul><li>May, 2007 </li></ul><ul><li>Call from HCF re: patient who had weakness, near paralysis after ingestion of “puffer fish” </li></ul><ul><li>Dx: Tetrodotoxin poisoning </li></ul><ul><li>FDA recall </li></ul>
  17. 17. Winter 2005 - 2006 <ul><li>Bootmate sealant </li></ul><ul><li>Exposures reported to PCC led to respiratory symptoms ranging from cough to pneumonitis to pulmonary edema </li></ul><ul><li>Initially noted by Detroit Poison Center </li></ul><ul><li>Investigation showed over 179 exposures with mild to severe clinical effects in midwest and eastern U.S. </li></ul><ul><li>Product recalled </li></ul>
  18. 18. Education <ul><li>Advanced HAZMAT Life Support (AHLS) </li></ul><ul><li>Bioterrorism Training and Curriculum Development Program (BTCDP) </li></ul><ul><li>Individual Lectures </li></ul>
  19. 19. Advanced HAZMAT Life Support <ul><li>The Advanced Hazmat Life Support (AHLS) Provider program </li></ul><ul><li>16 hour, two-day course that gives health professionals a timely and effective response strategy in the medical management of hazmat incidents. </li></ul><ul><li>Participants will receive a four-year verification status upon successful completion of the course. </li></ul>
  20. 20. Advanced HAZMAT Life Support <ul><li>This course covers a vast array of hazardous materials, including pesticides, corrosives, toxic inhalants and chemical, biological, radiological and nuclear agents. </li></ul><ul><li>The AHLS Provider course trains the participant to: </li></ul><ul><ul><li>Rapidly assess hazmat patients </li></ul></ul><ul><ul><li>Recognize toxic syndromes (toxidromes) </li></ul></ul><ul><ul><li>Apply the poisoning treatment paradigm </li></ul></ul><ul><ul><li>Identify and administer specific antidotes </li></ul></ul>
  21. 22. Education - AHLS
  22. 23. Advanced HAZMAT Life Support <ul><li>Since October 2002 </li></ul><ul><li>14 provider courses </li></ul><ul><li>4 Instructor courses </li></ul><ul><li>1 Chemical burn course (1/2 day course) </li></ul><ul><li>488 individuals trained </li></ul>
  23. 24. Advanced HAZMAT Life Support <ul><li>Free to Illinois Residents through ASPR Hospital Preparedness funds </li></ul><ul><li>Out of state participants - $425 </li></ul><ul><li>16 hours CME provided </li></ul><ul><li>Register On-line at </li></ul>
  24. 25. AHLS
  25. 27. Advanced HAZMAT Life Support <ul><li>Prefer co-sponsorship with health care entities throughout the state </li></ul><ul><li>IPC provides books (which have CME attached to cost of $265), instructors, program organization </li></ul><ul><li>Co-sponsor coordinates room, food, and most importantly “local touch” (e.g. restaurant recommendations, nightlife, etc) </li></ul>
  26. 28. Advanced HAZMAT Life Support <ul><li>Courses this summer: </li></ul><ul><li>July 26-27 Metropolitan Chicago Healthcare Council </li></ul><ul><li>August 3-4 in conjunction with Rockford Health Systems </li></ul><ul><li>August 13-14 in conjunction with Loyola University Medical Center </li></ul>
  27. 29. Education – Bioterrorism Training and Curriculum Development Program <ul><li>Coordinated by MCHC </li></ul><ul><li>Partners include: RUSH, John H. Stroger Jr. Hospital of Cook County, University of Chicago, Mt. Sinai, University of Illinois, Loyola University Medical Center </li></ul>
  28. 30. BTCDP <ul><li>IPC, Stroger and UIC formed partnership in content development for bioterrorism training lectures </li></ul><ul><li>5 hour course curriculum </li></ul><ul><li>Overview of Disaster Planning, Biological, Chemical and Nuclear Agents, Overview of Disaster planning implementation </li></ul>
  29. 31. BTCDP <ul><li>Five hour course curriculum being transferred to web based modules for asynchronous learning </li></ul><ul><li>Available soon from MCHC web site </li></ul>
  30. 32. Education – Individual Lectures <ul><li>BTCDP course with five lectures, all have the capability to be stand alone lectures </li></ul><ul><li>Other disaster and toxicology related lectures available </li></ul><ul><li>50 one-hour lectures delivered 2004 thru 2006 with 16 related to bioterrorism </li></ul>
  31. 33. Information <ul><li>Call Center based </li></ul><ul><li>Web-based </li></ul><ul><ul><li>Health Care Professional pages </li></ul></ul><ul><ul><li>General Public pages </li></ul></ul>
  32. 34. Web based Health Care Professional pages <ul><li>Biological, Chemical and Nuclear fact sheets </li></ul><ul><li>2 page limit – emergency recognition and treatment </li></ul>
  33. 36. Web based General Public <ul><li>3,665 downloads of BT information for the general public Sept, 2006 thru June, 2007 </li></ul>
  34. 43. General Public Bioterrorism Spanish Language Pages <ul><li>Latino population 14.3% of 12.8 million people </li></ul><ul><li>In 2000, 10% of Illinoisans considered Spanish as being the primary language of the household </li></ul>
  35. 44. Call Center Services <ul><li>Normal Services </li></ul><ul><ul><li>107,000 calls in 2006 </li></ul></ul><ul><ul><li>Over 87,000 exposures </li></ul></ul><ul><ul><li>Over 15,000 calls from hospitals and healthcare professionals </li></ul></ul><ul><li>Developed 4 tiered plan for surge capacity </li></ul>
  36. 45. Separate Disaster Line <ul><li>1-866-331-9191 </li></ul><ul><li>Staff or volunteers to answer phone lines dedicated to the disaster </li></ul><ul><li>Scripted messages </li></ul><ul><li>Provide information to decrease surge on hospitals or local health departments </li></ul><ul><li>Based on AHRQ program from Rocky Mountain Poison and Drug Center </li></ul>
  37. 46. Disaster phone lines <ul><li>IPC </li></ul><ul><li>MCHC – phone bank of 20 phones. Plan to be staffed by INVENT volunteers </li></ul><ul><li>LUMC – phone bank of 20 phones. Plan to be staffed by medical student volunteers </li></ul>
  38. 47. Draft Four Tiered Response Plan Roll over lines to other out of state disaster lines to increase capacity Tier Four <ul><li>Mobilization of local resources: </li></ul><ul><li>open up call center in MCHC board room </li></ul><ul><li>LUMC for INVENT and other volunteers </li></ul>Tier Three IPC will call in those employees who are off to answer calls on telecommuting stations from home for additional coverage Tier Two IPC staff answer disaster line phones in poison center in addition to regular duties Tier One
  39. 48. Tiered Response <ul><li>Tier Two – home office in pilot phase </li></ul><ul><ul><li>Covers social distancing for pandemic flu </li></ul></ul><ul><li>Tier Four – Rollover to other call center phone banks or poison centers </li></ul><ul><ul><li>Preferred to have common carrier – major barrier to progress </li></ul></ul><ul><ul><li>Potentially could have scripted automated messages prior reaching ‘live person’ when volume is high. </li></ul></ul>
  40. 49. Summary <ul><li>Introduction to the Illinois Poison Center </li></ul><ul><li>Surveillance and Reporting </li></ul><ul><ul><li>Software surveillance, Individual Reporting </li></ul></ul><ul><li>Education </li></ul><ul><ul><li>AHLS, BTCDP, individual lectures/presentations </li></ul></ul><ul><li>Information </li></ul><ul><ul><li>Web based for health care and general public </li></ul></ul><ul><li>Call center services and surge capacity </li></ul>
  41. 50. <ul><li>? </li></ul>