Use of clinical toxicology resources by emergency physicians and its impact on poison control centers. 1991

E M Caravati, and N E McElwee
Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City.

OBJECTIVE The need for clinical toxicology resources by emergency physicians is unclear and may have implications for future training and resource availability. This study was designed to assess current emergency physician use of available resources. METHODS Prospective evaluation by mail using a 49-item questionnaire. METHODS All 170 emergency physicians in Utah. METHODS None. RESULTS The response rate was 75.3% (128 of 170). Resources "outside their own fund of knowledge" were consulted "occasionally" to "frequently" by 98.3%. They used the following resources "occasionally" to "frequently": poison control center (PCC) (93.7%), toxicology textbook (77.6%), "expert colleague" (34.0%), and "in-house POISINDEX" (23.9%). They often contacted the PCC for toxicity information (93.7%) and management recommendations (87.3%) and for acute, symptomatic overdose cases (88.3%). They "almost never" contacted the PCC for adverse drug reactions (76.6%), pill identification (70.2%), consultation with physician toxicologist (68.1%), asymptomatic exposures (62.9%), chronic toxicity (50.4%), or solely to report the case to the American Association of Poison Control Centers data base (90.2%). Those who had access to in-house POISINDEX often did not consult the PCC (82.6%). Of those who did not have in-house POISINDEX, 42.8% contacted the PCC to access it. Providing access to physician toxicologist consultations was thought to be an important role for the PCC by 86.7%, but only 32% of physicians were using this option. CONCLUSIONS The vast majority of emergency physicians in Utah consult the PCC only for acute, symptomatic overdoses. They view access to physician toxicologist consultation as an important role for the PCC but seldom use it. The availability of in-house POISINDEX decreases the likelihood of PCC consultations from emergency departments. The frequency of emergency physician consultation with the PCC may decrease as POISINDEX becomes available at more hospitals.

UI MeSH Term Description Entries
D009862 Online Systems Computer-based Information systems having real-time remote access to information or processes. On-Line Systems,On Line Systems,On-Line System,Online System,System, On-Line,System, Online,Systems, On-Line,Systems, Online
D011039 Poison Control Centers Facilities which provide information concerning poisons and treatment of poisoning in emergencies. Centers, Poison Control,Center, Poison Control,Control Centers, Poison,Poison Control Center
D011041 Poisoning A condition or physical state produced by the ingestion, injection, inhalation of or exposure to a deleterious agent. Poisonings
D004635 Emergency Medicine The branch of medicine concerned with the evaluation and initial treatment of urgent and emergent medical problems, such as those caused by accidents, trauma, sudden illness, poisoning, or disasters. Emergency medical care can be provided at the hospital or at sites outside the medical facility. Medicine, Emergency
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014116 Toxicology The science concerned with the detection, chemical composition, and biological action of toxic substances or poisons and the treatment and prevention of toxic manifestations. Toxinology,Evidence Based Toxicology,Evidence-Based Toxicology,Based Toxicologies, Evidence,Based Toxicology, Evidence,Evidence Based Toxicologies,Evidence-Based Toxicologies,Toxicologies, Evidence Based,Toxicologies, Evidence-Based,Toxicology, Evidence Based,Toxicology, Evidence-Based
D014589 Utah State bounded on the north by Idaho and Wyoming, on the east by Wyoming and Colorado, on the south by Arizona, and on the west by Nevada.
D016208 Databases, Factual Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references. Databanks, Factual,Data Banks, Factual,Data Bases, Factual,Data Bank, Factual,Data Base, Factual,Databank, Factual,Database, Factual,Factual Data Bank,Factual Data Banks,Factual Data Base,Factual Data Bases,Factual Databank,Factual Databanks,Factual Database,Factual Databases
D062787 Drug Overdose Accidental or deliberate use of a medication or street drug in excess of normal dosage. Drug Overdoses,Overdose, Drug,Overdoses, Drug

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