Cargando…

A retrospective review of 911 calls to a regional poison control center

BACKGROUND: There is little data as to what extent national Emergency Medical Services (EMS; 911) utilize poison control centers (PCCs). A review of data from our PCC was done to better understand this relationship and to identify potential improvements in patient care and health care savings. METHO...

Descripción completa

Detalles Bibliográficos
Autores principales: Bosak, Adam, Brooks, Daniel E., Welch, Sharyn, Padilla-Jones, Angie, Gerkin, Richard D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776607/
https://www.ncbi.nlm.nih.gov/pubmed/26985414
http://dx.doi.org/10.4103/2249-4863.174285
_version_ 1782419174613581824
author Bosak, Adam
Brooks, Daniel E.
Welch, Sharyn
Padilla-Jones, Angie
Gerkin, Richard D.
author_facet Bosak, Adam
Brooks, Daniel E.
Welch, Sharyn
Padilla-Jones, Angie
Gerkin, Richard D.
author_sort Bosak, Adam
collection PubMed
description BACKGROUND: There is little data as to what extent national Emergency Medical Services (EMS; 911) utilize poison control centers (PCCs). A review of data from our PCC was done to better understand this relationship and to identify potential improvements in patient care and health care savings. METHODS: Retrospective chart review of a single PCC to identify calls originating from 911 sources over a 4-year study period (1/1/08–12/31/11). Recorded variables included the origin of call to the PCC, intent of exposure, symptoms, management site, hospital admission, and death. Odds ratios (OR) were developed using multiple logistic regressions to identify risk factors for EMS dispatch, management site, and the need for hospital admission. RESULTS: A total of 7556 charts were identified; 4382 (58%) met inclusion criteria. Most calls (63.3%) involved accidental exposures and 31% were self-harm or misuse. A total of 2517 (57.4%) patients had symptoms and 2044 (50.8%) were transported to an Emergency Department (ED). Over 38% of calls (n = 1696) were handled primarily by the PCC and did not result in EMS dispatch; only 6.5% of cases (n = 287) with initial PCC involvement resulted in crew dispatch. There were 955 (21.8%) cases that resulted in admission, and five deaths. The OR for being transported to an ED was 45.4 (95% confidence interval [CI]: 30.2–68.4) when the crew was dispatched by the PCC. Hospital admission was predicted by intent for self-harm (OR 5.0; 95% CI: 4.1–6.2) and the presence of symptoms (OR 2.43; 95% CI: 1.9–3.0). The ORs for several other predictive variables are also reported. CONCLUSIONS: When 911 providers contact a PCC about poisoning-related emergencies, a history of intentional exposure and the presence of symptoms each predicted EMS dispatch by the PCC, patient transport to an ED, and hospital admission. Early involvement of a PCC may prevent the need for EMS activation or patient transfer to a health care facility.
format Online
Article
Text
id pubmed-4776607
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-47766072016-03-16 A retrospective review of 911 calls to a regional poison control center Bosak, Adam Brooks, Daniel E. Welch, Sharyn Padilla-Jones, Angie Gerkin, Richard D. J Family Med Prim Care Original Article BACKGROUND: There is little data as to what extent national Emergency Medical Services (EMS; 911) utilize poison control centers (PCCs). A review of data from our PCC was done to better understand this relationship and to identify potential improvements in patient care and health care savings. METHODS: Retrospective chart review of a single PCC to identify calls originating from 911 sources over a 4-year study period (1/1/08–12/31/11). Recorded variables included the origin of call to the PCC, intent of exposure, symptoms, management site, hospital admission, and death. Odds ratios (OR) were developed using multiple logistic regressions to identify risk factors for EMS dispatch, management site, and the need for hospital admission. RESULTS: A total of 7556 charts were identified; 4382 (58%) met inclusion criteria. Most calls (63.3%) involved accidental exposures and 31% were self-harm or misuse. A total of 2517 (57.4%) patients had symptoms and 2044 (50.8%) were transported to an Emergency Department (ED). Over 38% of calls (n = 1696) were handled primarily by the PCC and did not result in EMS dispatch; only 6.5% of cases (n = 287) with initial PCC involvement resulted in crew dispatch. There were 955 (21.8%) cases that resulted in admission, and five deaths. The OR for being transported to an ED was 45.4 (95% confidence interval [CI]: 30.2–68.4) when the crew was dispatched by the PCC. Hospital admission was predicted by intent for self-harm (OR 5.0; 95% CI: 4.1–6.2) and the presence of symptoms (OR 2.43; 95% CI: 1.9–3.0). The ORs for several other predictive variables are also reported. CONCLUSIONS: When 911 providers contact a PCC about poisoning-related emergencies, a history of intentional exposure and the presence of symptoms each predicted EMS dispatch by the PCC, patient transport to an ED, and hospital admission. Early involvement of a PCC may prevent the need for EMS activation or patient transfer to a health care facility. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4776607/ /pubmed/26985414 http://dx.doi.org/10.4103/2249-4863.174285 Text en Copyright: © 2015 Journal of Family Medicine and Primary Care http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Bosak, Adam
Brooks, Daniel E.
Welch, Sharyn
Padilla-Jones, Angie
Gerkin, Richard D.
A retrospective review of 911 calls to a regional poison control center
title A retrospective review of 911 calls to a regional poison control center
title_full A retrospective review of 911 calls to a regional poison control center
title_fullStr A retrospective review of 911 calls to a regional poison control center
title_full_unstemmed A retrospective review of 911 calls to a regional poison control center
title_short A retrospective review of 911 calls to a regional poison control center
title_sort retrospective review of 911 calls to a regional poison control center
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776607/
https://www.ncbi.nlm.nih.gov/pubmed/26985414
http://dx.doi.org/10.4103/2249-4863.174285
work_keys_str_mv AT bosakadam aretrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT brooksdaniele aretrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT welchsharyn aretrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT padillajonesangie aretrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT gerkinrichardd aretrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT bosakadam retrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT brooksdaniele retrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT welchsharyn retrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT padillajonesangie retrospectivereviewof911callstoaregionalpoisoncontrolcenter
AT gerkinrichardd retrospectivereviewof911callstoaregionalpoisoncontrolcenter