TPCN SPI Spotlight: South Texas Poison Center Arika Mike

1. Tell me your history with poison control and how you became a SPI. (Length of time worked there/background/passion for this, etc.)

I have worked as a SPI for nearing two years, starting at the New Mexico Poison & Drug Information Center and now currently at the South Texas Poison Center. I have had an interest in poison control since I was a student pharmacist at the University of New Mexico College of Pharmacy. I served as Poison Prevention Co-Chair for the Student Society of Health-System Pharmacy professional organization at my school during my 2nd year and completed a rotation at the New Mexico Poison & Drug Information Center during my 4th year. After graduating pharmacy school, I completed a PGY-1 Community Pharmacy Residency with Baylor Scott & White Health. I was able to do a rotation at the Central Texas Poison Center where my passion for poison control grew even further. I appreciate that I get to directly help my community by providing quality information to patients and providers in emergency situations.

2.  I’m sure you hear a lot of interesting stories when answering calls, but what is one story that sticks out in your head that might have been scary, but turned out funny and/or everything worked out after the call.

I got a call from a mom recently and her child had got into a Tide Pod that had burst in the child’s mouth, the child was vomiting at the time and mom was very concerned. I told mom that we can watch this at home since it had just happened and sometimes the soap in the Tide Pods can be upsetting to the stomach. I told mom what "red flag" symptoms that she would need to go immediately to the hospital for (continued vomiting, trouble breathing, drowsiness or coughing). When I called back mom didn’t answer, but after the second call a few hours later I was able to speak with mom. She ended up taking the child to the hospital because of drowsiness. The patient developed no further symptoms at the hospital. Mom voiced gratitude for poison control being there to walk her through a scary situation and that I had taken the time to follow-up with her to make sure the child was okay.

3. What do you think people need to know about the people who answer the phones for poison control?

Often callers wonder why we ask so many questions during a call from their child’s weight to whether they have any health problems. I think people need to know that the specialists who answer the phones are healthcare providers who are actively making decisions that impact each individual patient’s care.

4. What do you enjoy most about your job and why?

As a pharmacist I have always enjoyed explaining something that can be complex in a way that a patient can understand. With poison control I am able to do this, and I enjoy working with unique and interesting cases.

5. Why do you think it is important for people to have poison control as a resource for emergency help?

I think it is important for people to have poison control as a resource because many exposures can be managed at home, which is a huge cost saver for patients and for the public.

How Poison Centers Work and How They Can Help You

Every day, by the hour, lives are being saved. Why? Because of the presence of poison control centers. Across the nation there exist 55 poison centers who assist with various poisoning emergencies as well as answer questions and provide any information to help prevent poisonings. Specially trained poison experts, known as Specialists in Poison Information (SPI), at each poison center include nurses, pharmacists, toxicologists and physicians. They can be reached 24 hours a day by calling the toll-free Poison Help line at 1-800-222-1222, which then connects you with your local poison center.

History of a Poison Center

The idea for a poison center came from a part-time secretary from the American Academy of Pediatrics during the early 1950s. The secretary contacted hospitals in Chicago to find out why children were in the emergency room with certain problems. What had they eaten? What did they drink?

At the time, companies did not have to tell people much about the ingredients in their products. The secretary asked companies about the ingredients in their products that might be making children sick. She then asked a group of medical professionals to create treatment guidelines for as many products as possible. When doctors had questions, they would call her, and she would read medical advice to them off the note cards.

Soon after, the U.S. Surgeon General ordered copies of her 1,000 index cards to be sent to health departments across the country. From this, the first poison center was founded, and the idea spread throughout the nation.

What do Poison Centers Offer

·       Help with a poisoning emergency, which can often be treated over the phone rather than calling 911 or visiting the emergency room. (Which saves Emergency Rooms or Ambulance costs)

·       Medical advice for healthcare professionals and the general public.

·       Real-time de-identified data collection that aids in detecting public health emergencies.

·       Free and confidential help, with interpretation services available in over 100 languages.

·       Assistance with pill identification.

·       Help with all types of poisonings including insect, snake or spider bites, plants, household chemicals, medication mix ups or overdoses and more.

·       Poison Prevention Poster and Video Contest Annually 

·       Free educational materials

·       Free educational presentations

What information to have readily available when calling a poison control center?

·       How old is the patient?

·       About how much does the patient weigh?

·       What is the name of the product or substance involved? Be as specific as you can-it can help to have the bottle or packaging with you on the phone. Poison experts use a database that contains detailed information on thousands of products.

·       How much of the substance did the patient swallow, breathe in or get on their skin? If you don't know, the poison specialist will help you estimate.

Based on this information, the poison specialist will tell you what you need to do. It could be as simple as drinking some water or eating a Popsicle. In some circumstances, they may need to send you to the hospital. If so, they will ask which hospital you are closest to and call ahead to let them know you are coming.

The poison center will also collect a little bit of personal information from you for your medical chart-your first name, the patient's first name, your phone number and the zip code you are calling from. This information is confidential. This information is important because it helps us to find your case if you need to call us back for any reason.

For questions or concerns, call the Texas Poison Center Network experts at 1-800-222-1222.

Poison Experts Warn Against Using Medications or Household Products to Prevent Coronavirus

The Texas Poison Center Network wants you and your family to stay safe from the current   

Coronavirus 2019 (COVID-19) pandemic. There are many steps you can take to protect yourself and others such as washing your hands frequently, practicing social distancing, and cleaning and disinfecting frequently touched surfaces.

While there is no vaccine against or cures for COVID-19, there are reports of products and medications that claim to “cure” or “protect” people from becoming ill circulating the internet; none of them approved for use and some of them potentially harmful.  Please remember that no medication or product should be used for COVID-19 without consulting your physician first. 

Some recent examples include individuals attempting to drink bleach to try and get rid of the coronavirus in their system.  This is of course not helpful and incredibly dangerous and should never be attempted.  Bleach is not intended for human consumption.   

  

Other examples include individuals taking the active ingredient in an anti-malarial drug to fight COVID-19. Chloroquine and hydroxychloroquine have been mentioned in many blogs and posts online as a possible “cure”.  They have even made it onto the President’s news conferences.  This came after a recent report that suggested these medications were being tested to treat COVID-19 in other countries.  There has been some improvement in critical patients taking these medications, but they are still in the early stages of testing.  We do know however that these ingredients are highly toxic and have caused many deaths due to ingestion.  There are reports of people who inadvertently have overdosed attempting to treat themselves with these products.   Texas Poison Centers want you to know that these medications and products can cause significant illness with permanent damage or death if taken in the incorrect dose or manner.

If you or someone you know has taken chloroquine or hydroxychloroquine, call the Poison Helpline at 1-800-222-1222 right away. If someone is experiencing seizures, difficulty breathing, turning blue or is unconscious, call 911 immediately.

If you are diagnosed with the COVID-19, please follow your doctor’s instructions and limit contact with others.  There is no specific cure or treatment.  If you are concerned about contracting coronavirus, now is the time to practice social distancing and only leave your home if absolutely necessary, such as for groceries or medications. For more information on COVID-19, please visit www.dshs.texas.gov/coronavirus.

Poison Prevention Week Brings Awareness to the Dangers of Potential Poisons

National Poison Prevention Week, March 15-21, 2020 is quickly approaching, and we want to take

this time to bring awareness to potential poisons and how you can stay safe. In 1961, the United States designated the third full week of March as National Poison Prevention Week, a week dedicated to highlighting the dangers of poisonings. Poisonings are currently the leading cause of injury related death in the country. Many of these poisonings can be preventable. And for those that aren’t always preventable, a poison expert is only a phone call away and ready to assist you.

In 2018, poison centers in the US received approximately 2.6 million calls on poison exposures. That means the poison centers averaged a new case about every 12 seconds. According to the Lewin Report, approximately $1.8 billion dollars was the amount of money poison control centers saved Americans in unnecessary medical costs in 2018. Because of these calls, the poison centers were able to help save lives and cut down visits to the emergency room.

Poison centers are an incredible help when it comes to major public health emergencies and epidemics. Since 2011, poison centers have handled over 500,000 calls relating to opioid misuse and abuse. They have also handled calls regarding trending issues such as liquid laundry packets, button batteries, synthetic drugs and, most recently, the coronavirus.

Poison centers assist the public with their poisoning concerns, but they also assist first responders and hospital personnel dealing with poison emergencies. Poison centers are an excellent resource. They even assist in identifying emerging drugs of abuse and provide countless hours of education to healthcare professionals and the general public.   

What is considered a poison?

A poison is any substance, including medications, which can be harmful to your body if ingested, inhaled, injected or absorbed through the skin. Accidental poisoning can occur when a person is unintentionally exposed to a substance without wanting to cause themselves harm.

Poisonings are more common than you think. According to the American Association of Poison Control Centers (AAPCC), approximately 90 percent of these poisonings are happening at home, with over half of them involving children under six years old.

Here are some poison facts and tips to remember:

• In children ages six and younger, the most common exposures are to medicines, personal care and cleaning products.
• Child-resistant packages are not childproof. Most two-year olds can open a child-resistant container in 3 minutes or less.
• Calling 1-800-222-1222 from anywhere in the United States will connect you to your regional poison center.  
• Keep all poisons locked up, away and out of reach of children.
• Never refer to medicine (prescription, vitamins or otherwise) as candy as children often mistake tiny pills for yummy candy.

What to do if you believe you have been exposed to a potential poison. 

In the event that you or someone with you has been potentially poisoned, always remember to first remain calm. Then immediately call the toll-free Poison Help line at 1-800-222-1222. Follow all the instructions you are given by the poison control specialist. Often, the poison control specialist will call back to make sure that things are okay. For more information on preventing poisonings, please visit the Texas Poison Center Network website at www.poisoncontrol.org.

TPCN SPI Spotlight: Hollie Blair, Central Texas Poison Center

Hollie Blair

1.      Tell me your history with poison control and how you became a Specialist in Poison Information (SPI).
I graduated from pharmacy school in 1990 and worked in retail pharmacy for 5 years before coming to the Poison Center.  During that time, I was diagnosed with undifferentiated spondylarthropy and was unable to stand for a prolonged time due to pain.  As a result, I had to find a job where I could sit down.  I called the College of Pharmacy to talk to some of my prior instructors to see if they had any ideas for where I might be able to work.  Luckily, Doug Borys had called the College of Pharmacy only a few days prior to my call, and he was looking for pharmacists to work at the newly formed Poison Center in Temple.  Talk about good timing!  I interviewed shortly afterward and have been working here at Poison Center for 25 years this June.

2.      I’m sure you hear a lot of interesting stories when answering calls, but what is one story that sticks out in your head that might have been scary but turned out funny and/or everything worked out after the call. One story I recall was a toddler that ingested a bite out of his grandmother’s post-mastectomy prosthetic breast!  We assured her it was not toxic but was a choking hazard.  The child remained asymptomatic.

3.      What do you think people need to know about the people who answer the phones for poison control?
The people at the Poison Center may feel like they are playing a game of 20 questions with you, but rest assured they are only gathering information which will help them to make a well-informed recommendation!

4.      What do you enjoy most about your job and why?
The thing I love most about my job is the diversity of calls we get on a daily basis and having the opportunity to help people during a stressful situation.

5.      Why do you think it is important for people to have poison control as a resource for emergency help?
I believe having the Poison Center as a resource for emergency help is vital to the growing burden on our emergency rooms.  If we can determine that a patient can be monitored at home, it will save both time and money for both the patient and the healthcare system in general.

Potentially Dangerous Toys to Be Aware of this Holiday Season

It’s the most wonderful time of year! As people start heading to the stores to purchase neat toys for their loved ones, it is important to be aware of the toys that could pose a potential danger to children. A consumer safety group called PIRG (Public Interest Research Groups) recently released its annual report on dangerous toys this holiday season. Some of the toys that made this list can also be potential poisons. Here are some of the things to look out for this holiday season.

Slime

Slime- you see it everywhere these days due to its popularity with children. There are products that now sell a set with of all the ingredients needed for children to make their own slime. One of these slime making kits from Nickelodeon, is labeled “Frozen Treats Slime” and is marketed as smelling just like ice cream. But the packaging also states that the set contains harmful ingredients that should not be ingested. These slime packages can be a lot of fun for children, but it is extremely important that they are being monitored by an adult when playing.  Slime is not made for ingesting and should be kept out of children’s mouths.

Some slime products contain a substance called borax. Borax is a naturally occurring mineral, but natural is not synonymous to safe. Ingesting borax could cause adverse reactions such as:

·         Rash or burn to skin or mouth

·         Nausea and Vomiting

·         Respiratory problems

·         Long term reproductive health issues

Ingesting even a small amount of borax could potentially cause vomiting and diarrhea.  Larger amounts could cause more severe symptoms.  If you or a loved one consumes slime with borax, please do not hesitate to reach out to the Texas Poison Center Network for help at 1-800-222-1222. The call is free and is answered 24 hours a day, 7 days a week. If you are looking for a slime recipe that doesn’t include borax, click this link to learn more.

Children’s Play Make-Up

Make-up can be fun for children to play with, but it can also be a cause for concern. Last year, asbestos was found in some make-up kits.  Most make-up products are not tested or required to pass any safety standards to ensure they are free of dangerous chemicals. Therefore, it is best to err on the side of caution and check the ingredients yourself if you are purchasing play make-up. We recommend avoiding these products altogether, but if you are purchasing a make-up play set, make sure the products are contaminant and talc-free (talc can be a source of asbestos).

Exposure to asbestos can cause several health cancers including mesothelioma. If you or a loved one believes they have come in contact with asbestos, please call the Texas Poison Center Network at 1-800-222-1222.

Jewelry with Toxic Metals

Children’s jewelry is usually made from a variety of metallic and plastic materials.  Some manufacturers have been known to use heavy metals to include cadmium. Cadmium is a known carcinogen and can hinder brain development in children. Therefore, it is not a good idea to purchase cheap jewelry for young children who might potentially put these items in their mouths.

Button Batteries

Button batteries are smaller than a penny. These lithium batteries can be found in many children’s toys as well as remote controls and watches. The reason these can be dangerous is if you were to swallow one, it could cause life-threatening damage. The battery can cause burn damages to the esophagus, difficulty swallowing and breathing, and sometimes death. If you might suspect your child swallowed a button battery, please call the poison hotline as soon as possible.

Older Toys (and some new toys) that can Contain Lead

Beware when re-gifting older toys as they can contain lead. There are also some newer toys (musical instruments available on-line), that through an investigation by the Wall Street Journal, were found to contain illegal levels of lead.

Why is lead dangerous? When a child puts objects containing lead in their mouths, the child can get lead poisoning. Lead is toxic to humans and animals. It can cause serious health issues and even low levels of lead in the blood can cause:

• Behavior and learning problems
• Hyperactivity
• Slowed growth
• Hearing Issues
• Anemia

In rare cases, it can also cause seizures, coma, and even death. If you are concerned you or a loved one might have encountered lead, please do not hesitate to reach out to the poison center.

The Texas Poison Center Network wants everyone to have a safe holiday and for presents to be poison-free! If you have any issues or concerns about any toys, including the ones we shared with you today, don’t hesitate to call.  Our phone lines are answered by pharmacists, nurses and toxicologists ready to help you with your poison concerns. Program the number in your phone so you always have it handy: 1-800-222-1222.

Have a Healthy & Happy Thanksgiving

As we get closer to celebrating Thanksgiving with family and friends, it’s important to keep in mind safety precautions you should practice in order to stay healthy. Follow these important tips from the Texas Poison Center Network (TPCN) to assist you in having a poison-free Thanksgiving holiday.

As you prepare your feast, please keep these tips in mind:

• Store and prepare food safely. Food poisoning is usually due to poor food handling practices. Symptoms can include fever, headache, diarrhea, abdominal discomfort and vomiting. Food poisoning usually occurs when bacteria gets on the food, then enters the body and make you sick. Wash hands, dishes, utensils, kitchen equipment and work surfaces before and after handling food. Be particularly careful with knives and cutting boards, washing them thoroughly after each use. Refrigerate or freeze perishable food within 2 hours of shopping or preparing; 1 hour when the temperature is above 90°F.
• Salmonella is a common cause of food poisoning and while it’s normally not fatal, it is widespread. Symptoms of salmonellosis include diarrhea, fever and abdominal cramping, with onset about 12 to 72 hours after infection; the illness usually lasts 4 to 7 days. Most people recover without treatment, but diarrhea and dehydration may be so severe that some people need hospital care. It is typically found in raw meats, poultry, eggs, milk, fish and their bi-products. Salmonella can be destroyed by cooking food thoroughly to an internal temperature of at least 140 degrees.
• When frozen, a turkey is safe indefinitely. But as soon as it starts to thaw, bacteria that may have been there before freezing can start to grow again if it is not kept at a safe temperature. It’s okay to thaw the turkey in its original plastic for one to two days, but after that, move the turkey to a plastic container, wrap, or foil. Don’t keep it in its original wrapping for more than two days once it has started to thaw.
• Thaw turkey or poultry inside the fridge; do not thaw at room temperature or in water.   
• Don’t stuff the turkey in advance and then refrigerate it. The core of the turkey is a perfect place for bacteria to grow. Remove all stuffing before refrigerating leftover meats. Keep the stuffing, gravy or broth in a separate container.
• Be careful around the booze. Adults should always drink responsibly, but in large gatherings, it’s important to be mindful of small children – particularly those who aren’t afraid to pick up discarded cups left behind by adults. Even a small amount of alcohol can poison a child.
• Be wary of choking hazards. Peanuts, raisins, hard candies, cocktail sausages and other hors d’oeuvres are tasty additions to any holiday meal, but they can be choking hazard
  s for the littlest partiers. Many pediatricians advise that children under the age of one year avoid nuts, because of the risk of allergies. Keep these foods out of the reach of very young children to prevent a choking incident. 

If you have any concerns or questions regarding poisonings, please do not hesitate to contact us! Commit this number to memory or simply save it in your phone contacts: 1-800-222-1222. We are here when you need us, 24/7. Happy Thanksgiving!