Emergency Department Poison Advice Telephone Calls

Abstract Study objective: Requests for medical advice regarding treatment of poisonings are common in emergency departments. Although there are designated poison centers (PCs), most EDs are recognized by the community and medical staff as a poison information resource. The purpose of this study was to evaluate the accuracy and consistency of poison information given by ED personnel. Design: A prospective, stratified-sample, telephone survey over a 6-month period of requests for medical advice about simulated poison ingestions. Participants: Fifty-two hospital EDs in urban and rural Illinois, all three PCs in Illinois, and three PCs from Indiana, Wisconsin, and Michigan. Results: Hospital EDs responded correctly to only 100 of 156 calls (64.2%). PCs responded correctly to 17 of 18 calls (94.4%), whereas teaching hospitals responded correctly to 15 of 30 calls (50%, P =.002). ED night shift personnel were 5.5 times more likely to respond incorrectly than were personnel on other shifts (95% confidence interval, 2.72 to 11.12). Forty-eight percent of all calls to EDs resulted in advice to call the regional PC. Conclusion: Poison advice by ED personnel proved to be inaccurate and inconsistent. As a result, patients may be better served if advice calls are redirected to regional PCs. [Wigder HN, Erickson T, Morse T, Saporta V: Emergency department poison advice telephone calls. Ann Emerg Med March 1995;25:349-352.]