Poison information center

Poison information center


       Importance of having a PIC and its various functions

       Organization of a PIC


After completion of this lecture, student will be able to:

       Describe the importance of having a PIC and its various functions

       Describe the organization of a PIC


       Provision of information regarding the identification and treatment aspects related to poisoning with any compound

Reason for establishing PIC

       To end accidental poisoning deaths in children

       To provide rapid access to information valuable in assessing & treating the poisoning

       To assist with poison prevention


       Assess and make treatment recommendations during poisonings

       Provide public and professional educational programs

       Collect & analyze the data on poisoning

       Perform research

       Assist public and healthcare providers during hazardous material spills

Differences between DIC & PIC

a) Clientele

    DIC -- HCP (only 10% from public)

    PIC -- Public (88%)

b) Call volume

    DIC -- < 7 calls /day

    PIC -- 103 calls/day/regional center (range: 33 to 213)

c) Administration difference

   i)  Hours of operation

    DIC:  9 AM to 5 PM on weekdays

    PIC:  24 hours a day year round

   ii) Cost

    DIC:  Less expensive

    PIC:  More expensive

   iii) Staffing

    DIC:  Pharmacist, Less number

    PIC:  Pharmacist / Physician / Nurse, More number

   iv) Funding

    DIC: Sponsoring hospital/medical centre

    PIC: Public/ industry contacts / organized donation program

d) Procedural difference

   i) Response time

    DIC: Average 15 to 30 minutes (may extend to days)

    PIC: Immediate response (average time --5 minutes)

   ii) Call complexity

    DIC:  More complex

    PIC:  Less complex

   iii) References

    DIC:  Less number of references

    PIC:  More number of references

   iv) Documentation (DIC & PIC)

       General epidemiological data (date, time & reason)

       Caller characteristics (site and place)

       Patient characteristics (age, sex, pregnancy)

       Exposure characteristics (substance, route and                  site of exposure)

       Clinical course (clinical status, medication given)

       Medical management (therapeutic intervention)

Organization of PIC

In organizing a PIC, consider “ideal human exposure call volume” anticipated

a)      Personnel

       Is important element of PIC

       Needs unique qualifications and training

       Has distinct responsibilities

i) Medical director

         Responsible for all medical aspects of PIC’s  operation

       Regular review of and authorization of all poisoning management protocols

       Authorization of poison center polices and procedures

       Participation in staff training

        Provision of an-call clinical support for PIC staff

        Participation in quality assurance activities

       Liaison with local medical societies, physicians

        Promotion of research

        Co-ordination of professional educational efforts

ii) Manager/supervisor

       Pharmacist/ physician/ nurse with training in the area of clinical toxicology




       Staffing schedule

       Staff supervision

       Staff training

       Maintenance of continuous quality improvement program

       Development of departmental policies/ procedures

       Preparation of administrative reports

       Media response

       Professional education

       Co-ordination of program with the sponsoring entities

iii) Poison information specialists

       Backbone of PIC

       Directly interact with HCP and patients

       PI specialist must be both clinicians and counselors

       Pharmacist / nurse are suitable



-Elicit complete history

-Assess correctly the severity of exposure

-Provides management plan

-Proper communication

-Follow up

iv) Public Education Co-ordinator

       To reduce the incidence of accidental poisoning in their service areas by teaching /educating public how to prevent poisonings

       Should have a background in education and media communication and experience as PI specialist


       Development, distribution and evaluation of poison prevention programs and materials

       Co-ordination of regularly occurring public education messages through the media

       Networking with schools and other organizations to provide cost-effective public education

       Co-ordination of poison prevention through poison information specialist

v) Other personnel

       Secretarial staff


       Postdoctoral fellowship


(b) Facility consideration

i) Location

»      Can be anywhere (but there should be access to telephone)

»      Ideal location is adjacent to emergency department

»      Other locations include library, pharmacy & schools of pharmacy

ii) Space

       100 to 200 square feet/ workstation

       Room for director / supervisor – should be adjacent to work place

       Rest room

       Proper ventilation, lighting, aeration & furniture etc

(c) Equipment's

       Telephone system – enough incoming lines (3 way calling)


       Fax machine, Internet, filing cabinets

       Refrigerator (if not located near cafeteria)

       Shelving to store articles and books

       UPS/ generator

(d) Resources




        Online data

(e) Policies and Procedures

       It may vary from center to center

       Method of operation

       Position of each persons and responsibilities     

(f) Training of PI specialists

Centre should provide training to staff in the following area

              (i) Clinical toxicology

             (ii) Communication

              (iii) Information retrieval

              (iv) Data collection/coding

              (v) Critical thinking

              (vi) Handling of telephone and other equipments

Performance evaluation






Quality Improvement Program

       To assess the level of performance of PIC

        To meet the demands of the need of the public/ health care providers

       If the demands are not met ,Centre should develop:

-Strategies and policies,

-Implement and re- assess in order to promote or increase the level of performance     


       Provision of information regarding the identification and treatment aspects related to poisoning with any compound

       Functions of PIC

       Difference between PIC AND DIC

       Organization of PIC

       Quality improvement programs

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