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In 1950, the American Academy of Pediatrics 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 poison center was created in Chicago in 1953.102 Although initially designed to provide information to health care professionals, both the popularity and the success of this center stimulated a poison center movement, which rapidly spread across the country. The myriad of new poison centers not only offered product content information to health care professionals, but also began to offer first aid and prevention information to members of the community.
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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.98,110,116 Concurrently, the number, configuration, and specific role of poison centers have shifted in response to public and professional needs.50,125
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Modern 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 role of the current American poison center can be best summarized as follows:
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Maintaining and interpreting a database of xenobiotics
Reducing health care costs related to poisoning through:
Providing information and advice to the public to prevent unnecessary hospitalizations following exposure
Providing information and advice to health professionals to improve the diagnosis and care of patients who present to health care
Collecting epidemiologic data on the incidence and severity of poisoning
Integrating epidemiologic data as part of the public health surveillance system
Educating health care professionals on the diagnosis and treatment of poisoning
Contributing to the science of toxicology
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In the past, poison centers were evaluated based on number of incoming calls and measures of community awareness. Current emphasis should be placed on evaluating health outcomes such as admissions to the intensive care unit, length of stay in hospitals, and total health care expenditures. One crucial test of the utility of modern poison centers will be their ability to help reverse the current trend in the United States of increasing adult mortality from prescription drug poisoning.67 This chapter explores some of the critical roles of US poison centers and ...