Contaminant identification: the importance of thorough interviewing techniques

The exact name of a contaminant is of extreme importance to the poison information specialist (SPI) in order to make a correct assessment of the poisoning exposure and to recommend proper treatment modalities. Incorrect contaminant information could lead to a serious and possibly fatal mistake on the part of the SPI. Thorough and effective interviewing techniques must be employed to avoid errors. We conducted a prospective study to determine how often misinformation is provided to the SPI at the time of the initial contact with the poison center. Over a 6-mo period 159 calls were identified in which the original caller mistakenly identified the contaminant. Fifty-two (33%) of these calls were received from health care professionals and 107 (67%) were from the lay public. Drug names were improperly reported in 80 cases, cleaning products in 26, cosmetics 14 times, general products 19, chemicals 7, rodenticides 8, and plants were incorrectly identified in 5 cases. In 110 of these cases, proper identification of the contaminant changed the assessment and also the treatment recommendations made by the SPI. Errors in contaminant identification occurs more frequently than is realized by poison center professionals. It is imperative to have the caller clarify the contaminant name by checking the container, when available, and supplying the SPI with as much information as possible. It is equally important that the SPI employ precise interviewing techniques to obtain information to avoid a serious error in assessment and treatment of the poisoned victim.