the illinois poison center and public health emergency

The Illinois Poison Center and Public Health

Emergencies

The Role of a Poison Center in The Role of a Poison Center in Preparedness and ResponsePreparedness and Response

Outline Introduction to the Illinois Poison

Center Surveillance and Reporting Education Information Call center services and surge

capacity

Introduction to IPC

Program of Metropolitan Chicago Healthcare Council (MCHC)

Mission

The Illinois Poison Center is dedicated to reducing the incidence and injury of poisoning in our communities through immediate expert telephone recommendations, innovative public and health care professional education and focused research.

Illinois Poison Center

Current Clinical Staffing:

16 Pharmacists and nurses

7 Poison information providers

3 Medical directors

Illinois Poison Center Staffed 24/7 Over 107,000 calls in 2006 Over 15,000 calls from health care

providers

Illinois Poison Center Part of the American Association of

Poison Control Centers Constant contact with other centers

Trends New products and toxicities Common Database

Clinical Surveillance Clinical surveillance (or Syndromic

Surveillance) refers to the systematic collection, analysis, and interpretation of health data about a clinical syndrome that has a significant impact on public health, which is then used to drive decisions about health policy and health education.

Surveillance Software-driven Surveillance of

National Poisoning Database System (NPDS)

Individual Reporting: High index of suspicion, clinical awareness Driven by experience

Software surveillance All exposure calls are logged into an

electronic program with two functions One function is the medical record:

Recorded history, physical, assessment and plan

The second is database All products are coded along with any

clinical symptoms noted

Software Surveillance The coded fields from every poison

center in the U.S, are uploaded every 20 minutes to New Jersey (essentially real-time)

The data is then analyzed with software developed in conjunction with the CDC (BIOSENSE)

Software Surveillance National Surveillance

three standard deviations from moving 14 day average for past three years creates a notification

Total Call Volume (by center) Human Exposure Volume (by center) Clinical Effects

Local Surveillance Training End of 2007

Can set for substances, clinical effects, adjust std dev Can set for zip codes

Individual Reporting Public Health Reporting by individuals

Astute clinician realizes something is out of the ordinary and reports it to other agencies

Recognition can occur in various points of patient care

Examples of Food Borne Illness Reporting

March 2004 Call to Illinois Poison

Center from HCF re: 2 individual with severe muscle breakdown

Recent ingestion of Buffalo Fish

Dx: Haff Disease

Examples of Food Borne Illness Reporting

Fall, 2006 Call from HCF regarding

patient with numbness, tingling and reversal of hot and cold

Patient recalls eating grouper at restaurant that night

Dx: Ciguatera Poisoning

Examples of Food Borne Illness Reporting

May, 2007 Call from HCF re: patient

who had weakness, near paralysis after ingestion of “puffer fish”

Dx: Tetrodotoxin poisoning

FDA recall

Winter 2005 - 2006 Bootmate sealant Exposures reported to PCC led to

respiratory symptoms ranging from cough to pneumonitis to pulmonary edema

Initially noted by Detroit Poison Center Investigation showed over 179 exposures

with mild to severe clinical effects in midwest and eastern U.S.

Product recalled

Education Advanced HAZMAT Life Support

(AHLS) Bioterrorism Training and Curriculum

Development Program (BTCDP) Individual Lectures

Advanced HAZMAT Life Support

The Advanced Hazmat Life Support (AHLS) Provider program

16 hour, two-day course that gives health professionals a timely and effective response strategy in the medical management of hazmat incidents.

Participants will receive a four-year verification status upon successful completion of the course.

Advanced HAZMAT Life Support

This course covers a vast array of hazardous materials, including pesticides, corrosives, toxic inhalants and chemical, biological, radiological and nuclear agents.

The AHLS Provider course trains the participant to: Rapidly assess hazmat patients Recognize toxic syndromes (toxidromes) Apply the poisoning treatment paradigm Identify and administer specific antidotes

Education - AHLS

Advanced HAZMAT Life Support

Since October 2002

14 provider courses 4 Instructor courses 1 Chemical burn course (1/2 day

course) 488 individuals trained

Advanced HAZMAT Life Support

Free to Illinois Residents through ASPR Hospital Preparedness funds

Out of state participants - $425 16 hours CME provided Register On-line at

www.illinoispoisoncenter.org

AHLS

Advanced HAZMAT Life Support

Prefer co-sponsorship with health care entities throughout the state

IPC provides books (which have CME attached to cost of $265), instructors, program organization

Co-sponsor coordinates room, food, and most importantly “local touch” (e.g. restaurant recommendations, nightlife, etc)

Advanced HAZMAT Life Support

Courses this summer: July 26-27 Metropolitan Chicago

Healthcare Council August 3-4 in conjunction with

Rockford Health Systems August 13-14 in conjunction with

Loyola University Medical Center

Education – Bioterrorism Training and Curriculum Development Program

Coordinated by MCHC Partners include: RUSH, John H.

Stroger Jr. Hospital of Cook County, University of Chicago, Mt. Sinai, University of Illinois, Loyola University Medical Center

BTCDP IPC, Stroger and UIC formed

partnership in content development for bioterrorism training lectures

5 hour course curriculumOverview of Disaster Planning, Biological, Chemical and Nuclear Agents, Overview of Disaster planning implementation

BTCDP Five hour course curriculum being

transferred to web based modules for asynchronous learning

Available soon from MCHC web site

Education – Individual Lectures

BTCDP course with five lectures, all have the capability to be stand alone lectures

Other disaster and toxicology related lectures available

50 one-hour lectures delivered 2004 thru 2006 with 16 related to bioterrorism

Information Call Center based Web-based

Health Care Professional pages General Public pages

Web based Health Care Professional pages

Biological, Chemical and Nuclear fact sheets 2 page limit – emergency recognition and

treatmentQuarterly Professional Page Visits and

Downloads

02,0004,0006,0008,00010,00012,000

1stQuarter

2ndQuarter

3rdQuarter

4thQuarter

2005

2006

2007

Web based General Public 3,665 downloads of BT information for the

general public Sept, 2006 thru June, 2007

0

100

200

300

400

500

sep nov jan mar may

Page visits and downloads

General Public Bioterrorism Spanish Language Pages

Latino population 14.3% of 12.8 million people In 2000, 10% of Illinoisans considered Spanish as

being the primary language of the household

0

100

200

300

400

500

600

jan feb mar apr may jun

Page visits and downloads

Call Center Services Normal Services

107,000 calls in 2006 Over 87,000 exposures Over 15,000 calls from hospitals and

healthcare professionals

Developed 4 tiered plan for surge capacity

Separate Disaster Line 1-866-331-9191 Staff or volunteers to answer phone

lines dedicated to the disaster Scripted messages Provide information to decrease surge

on hospitals or local health departments Based on AHRQ program from Rocky

Mountain Poison and Drug Center

Disaster phone lines IPC MCHC – phone bank of 20 phones.

Plan to be staffed by INVENT volunteers

LUMC – phone bank of 20 phones. Plan to be staffed by medical student volunteers

Draft Four Tiered Response Plan

Tier One IPC staff answer disaster line phones in poison center in addition to regular duties

Tier Two IPC will call in those employees who are off to answer calls on telecommuting stations from home for additional coverage

Tier Three

Mobilization of local resources:• open up call center in MCHC board

room • LUMC for INVENT and other

volunteers

Tier Four Roll over lines to other out of state disaster lines to increase capacity

Tiered Response Tier Two – home office in pilot phase

Covers social distancing for pandemic flu Tier Four – Rollover to other call

center phone banks or poison centers Preferred to have common carrier – major

barrier to progress Potentially could have scripted

automated messages prior reaching ‘live person’ when volume is high.

Summary Introduction to the Illinois Poison Center Surveillance and Reporting

Software surveillance, Individual Reporting Education

AHLS, BTCDP, individual lectures/presentations

Information Web based for health care and general public

Call center services and surge capacity

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