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Poison control center adapts, expands focus

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By Sun Advocate

Employees of the Utah Poison Control Center field calls at the facility in University of Utah’s research park. Last year, over 53,000 calls were received.

Ipecac syrup was the standard remedy for treating home poisonings when the Utah Poison Control Center was founded 50 years and more than one million phone calls ago.
For decades, mercury thermometers reliably told physicians and parents whether patients or children had a fever.
Bioterrorism was not part of the national vocabulary.
One-half of a century has brought marked change to the art and science of poison control.
The UPCC has evolved from a modest operation into modern poison control center in the University of Utah’s Research Park.
The facility has one from fielding four calls to answering 145 queries daily. The center responded to more than 53,000 calls last year.
“The needs for our services changed, and we’ve adapted to meet those needs,” said Barbara Insley Crouch, UPCC director and professor at the U of U College of Pharmacy. “We’ve grown from a small, professional service into a large, public one.”
In the beginning, the center acted primarily as a service for physicians seeking advice about potential poisonings.
Currently, the center works mostly with the public to answer calls about possible exposures and educate people about poison control.
In recent years, the Utah Poison Control Center has:
•Partnered with a chain of grocery stores to collect and exchange mercury thermometers for safer, digital ones.
Broken mercury thermometers are now considered poison threats.
•Began tracking calls for symptoms and trends that would indicate whether a chemical or biological agent has been released into the atmosphere.
•Joined a national network of more than 60 poison control centers tied to one phone number, 1-800-222-1222.
The toll-free number connects callers to their nearest poison control center.
•Introduced a web site, www.uuhsc.utah.edu/poison, with prevention tips, links to educational sites and information about the facility.
•Provided poison prevention education to all health districts in Utah through the train-the-trainer program.
Amid the changes, one constant has remained.
Martin Caravati, medical director and professor of surgery, said most poison threats involve children younger than 6 years old getting into common household items like cosmetics, over-the-counter medications and cleaning products.
“The greatest poisoning threat to children is still found in their own homes,” Caravati said. “That’s something we’re continually trying to educate parents about.”
Residents in Carbon County and at locations across the state call the UPCC at twice the rate of the national average.
According to Crouch and Caravati, there are two likely reasons for the increase in calls. First, the public is educated about where to call during a poison emergency. Second, the high percentage of Utah families with small children increases the need to call.
Through the years, UPCC has answered emergencies ranging from a teen’s near overdose on hallucinogenic jimson weed to identifying the chemicals that killed workers in an industrial accident. Occasionally, a toddler will press the speed-dial button on a home phone and the center will get a call. Once in a while, callers encounter a problem when a dog or other pet ingests a potentially dangerous substance and the owner doesn’t know where else to find information. In those cases, UPCC specialists do their best to help the caller or refer them to the national veterinary poison center if they need further help.
According to the center, it has been keeping statistics and tracking calls in 1971. The number was a comparatively modest 1,500, or about four calls a day, that year. Three years later, the number had increased eightfold to 12,000, or about 32 calls a day. Last year, UPCC staff responded to more than 53,000 calls.
“Anyone who calls the UPCC can know they’re being helped by a professional who is specially trained in toxicology,” commented Crouch.
Registered pharmacists, nurses, and physicians staff the center round-the-clock, every day of the year.
The UPCC was founded by pediatrician Alan K. Done, M.D., a member of the U medical school faculty. Initially, the center operated in the Salt Lake County General Hospital Emergency Department, and Done would consult with staff about poison emergencies as needed. When the new University of Utah Hospital opened in 1965, the poison center moved to the U campus and has remained there since then.
Anthony R. Temple, M.D., another medical school faculty member who’d joined the poison center staff in 1966, took over as director in 1971, when Done left to work for the U.S. Food and Drug Administration. Temple pioneered the concept of a regional poison control center, and the facility’s name was changed to Intermountain Regional Poison Control Center to reflect its expansion.
The College of Pharmacy’s involvement with UPCC started in the late 1960s when David George, Ph.D., a graduate student in pharmacology, attended a lecture by Done and became interested in the area of poisoning.
In 1970, Pharmacy Dean Ewart A. Swinyard embraced the idea of a poison center as a training site for pharmacy students who would answer calls. George assumed responsibility for coordinating pharmacy students’ work with the center and became associate director. The center now operates under the Department of Pharmacotherapy in the College of Pharmacy.
In addition to the national accreditation status of the center, the UPCC continues to be a training ground for students in the health professions. Each year, the UPCC staff train more than 20 pharmacy and medical students, as well as medical residents in emergency and pediatric emergency medicine.
Various agencies, including the Public Health Service, Medicaid, Utah Department of Health, University of Utah School of Medicine, College of Pharmacy and University Hospital have funded the center over the years. But a stable funding source had been hard to come by until 1998, when the Utah Legislature approved a 7 cent surcharge on all phone lines in the state, with the revenue going to the UPCC.
In 1993, the center’s administrative offices and hotline moved to Research Park, and in 2003, the UPCC moved to newer, roomier quarters also in Research Park.
With a half century of history to build on, Crouch and Caravati said they are mindful of the past and ready for the future.
“In a world of ever-changing chemicals, drugs, and poisons, we remain committed to providing personalized expert advice to the public and health professionals 24 hours a day,” Caravati said.

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