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Does prearrival communication from a poison center to an emergency department decrease time to activated charcoal for

Rachel E Tuuri1, Joseph L Wright, Jianping He

  • 1Division of Pediatric Emergency Medicine, Medical University of South Carolina, Charleston, SC, USA. rtuuri@hotmail.com

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Poison center referrals significantly speed up activated charcoal (AC) administration in pediatric poisoning cases. However, overall AC delivery times remain suboptimal, highlighting the need for improved emergency department and prehospital protocols.

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Area of Science:

  • Pediatric Emergency Medicine
  • Toxicology
  • Public Health

Background:

  • Poison centers are vital for managing poisoning cases and reducing associated morbidity.
  • Activated charcoal (AC) is a key intervention for specific poisonings.
  • Timely administration of AC is crucial for effective treatment.

Purpose of the Study:

  • To determine if children with poison center referrals receive activated charcoal (AC) earlier than those without.
  • To evaluate the impact of poison center communication on AC administration timeliness in pediatric patients.

Main Methods:

  • Retrospective review of pediatric emergency department (ED) cases (2000-2006).
  • Analysis of activated charcoal (AC) administration time based on poison center referral status.
  • Statistical control for covariates including age, sex, acuity, disposition, and transport mode.

Main Results:

  • 351 pediatric poisoning cases were analyzed.
  • Patients with poison center referrals received AC significantly faster (mean 59 minutes) compared to those without (mean 71 minutes).
  • A significant difference (P = 0.0036) was observed in AC administration time between the two groups.

Conclusions:

  • Poison center pre-announcements are associated with earlier activated charcoal (AC) administration in pediatric EDs.
  • Current AC administration times are frequently suboptimal, necessitating improvements in triage and prehospital practices.
  • Standardizing advanced notification by poison centers and implementing rapid response protocols in EDs are recommended.