EMERGENCY DEPARTMENT POISON ADVICE TELEPHONE CALLS

Study objective: Requests for medical advice regarding treatment of po isonings are common in emergency departments. Although there are desig nated poison centers (PCs), most EDs are recognized by the community a nd medical staff as a poison information resource. The purpose of this study was to evaluate the accuracy and consistency of poison informat ion given by ED personnel. Design: A prospective, stratified-sample, t elephone survey over a 6-month period of requests for medical advice a bout 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 responde d correctly to only 100 of 156 calls (64.2%). PCs responded correctly to 17 of 18 calls (94.4%), whereas teaching hospitals responded correc tly 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. Conclu sion: Poison advice by ED personnel proved to be inaccurate and incons istent. As a result, patients may be better served if advice calls are redirected to regional PCs.