You Are Never Going to Believe What Just Happened!

May 5, 2011 - Injury Free Coalition for Kids of Baltimore

So many items in the home and office are potential poisoning risks, from cleaners to medications to personal care items. Kids are particularly at risk of ingesting poisons because they don't always know the difference between what's safe and what's not. Bruce D. Anderson, director of operations at the Maryland Poison Center, has heard it all. He answers questions about who calls the center and what help they can get.

Who is most likely to get poisoned?

The short answer is: everyone. Everyone is at risk for poisoning. We routinely get calls from folks of all ages, all backgrounds and for all sorts of reasons. People call about possible toxic exposures at work or call to ask questions about their medications or call because their roommate took all of their medications at one time to try to hurt themselves. In fact, people call us about their pets getting into things. We hear about it all.

However, nearly half of the 35,000 or so human exposure calls the [Maryland Poison Center] manages each year involve a child under the age of 6 years who has gotten into something in their surroundings. Toddlers often stick things in their mouth as they explore their environment. Very young children also can't tell that the bright blue stuff in the bottle of window cleaner is actually window cleaner and not a sports drink. There are a lot of products that look like candy or food, but really are potentially toxic substances.

What are the most common household poisons, and are snake and insect bites also a problem?

The MPC gets calls about all sorts of products. You name it, we've probably been called about it and probably been called 1,000 times previously about that exact product or situation. Folks often tell us, "You're never going to believe what just happened …" Since the poison center arrived at the University of Maryland School of Pharmacy in 1972, we've managed over 1.9 million exposures. Most of those calls involve commonly available household products. If it's something found in every home, we'll get called about it commonly. Examples: cleaners like bleach and ammonia, over-the-counter medications like Tylenol and Motrin, common personal care items like toothpaste and deodorants, but also things like houseplants or mushrooms from the yard or pesticides. And, yes, we get calls about folks that have snakebites or spider bites. The bottom line: We get calls about everything. If you have a question, just call and we'll help you out.

Are there steps to take before calling for help?

The most important thing to do is to call and ask for help. The poison specialists that staff the MPC hot line are either pharmacists or nurses who have additional toxicology training and certification. They'll guide you through the process of trying to figure out what's happening. They will ask questions about what happened, who was exposed, what they were exposed to, how the patient is doing, what treatments have been provided and other questions. If possible, find the product container the person was exposed to. If someone was exposed to a medicine, get the pill bottle so that we can be sure exactly what the substance was, how much the person could have been exposed to, etc. It's also important to remember that if the patient isn't breathing, is seizing or bleeding profusely, then call 911.

Why not just call 911 when poisoning is suspected instead of a poison center?

Well, if the patient isn't breathing, is seizing or is bleeding profusely, then you need to call 911. If the patient is doing OK, just call the Maryland Poison Center. Why? We're the experts in dealing with poisonings. In fact, who do you think 911 calls when they have a poisoning case? In the vast majority of situations, with the help of the poison specialists, we can manage people safely at home without the need for an ambulance and a trip to the emergency department.

Who answers the phones at the Maryland Poison Center and where is it housed?

A: The folks that staff the MPC are all either pharmacists or nurses that work full time in the MPC. They all have additional toxicology training and certification. When you call the MPC, you're getting connected to the experts. In addition, those poison specialists are supported by a medical director who is board-certified in emergency medicine and medical toxicology, a director who is a board-certified toxicologist and a faculty member who [has a doctorate in pharmacology and] a master's in public health. In addition, we have outside consultants that are available for really unusual circumstances where additional expertise is needed (e.g., we have mycologists available for assistance identifying potentially toxic mushrooms, occupational medicine physicians for possible workplace exposures, etc.).

The MPC is a service program of the University of Maryland School of Pharmacy. The program has been hosted by the UM School of Pharmacy and providing free poison information service to Marylanders for the past 39 years. We're located on the UM Baltimore campus in downtown Baltimore.

What can you do to prevent poisonings?

There are a couple basics that everyone can do to try to prevent poisonings from occurring. Be aware of the potentially toxic products in your environment. That means know what's in your home, your garage, even the places you stay for your vacation. You can keep all medicines locked up. Just putting stuff higher up on a shelf or above the refrigerator doesn't prevent some children from getting into things.

Keep all products in their original containers. We commonly hear about exposures to things like cleaners or automotive products because they have been stored in soda bottles or some other container. Not only is it more likely that someone is going to accidentally drink the product, but once that exposure happens, people don't know exactly what was in the container. There's no label to tell you what the product is.

And, most importantly, know that if a poisoning does occur, you have access to the best available poison triage and treatment information by simply dialing 1-800-222-1222.