Poisons Information Bureau was established in the United States and England in 1950 and the first bureau in Great Britain was opened in the Consulting Department of the General Infirmary at Leeds in august 1961. The calls to the bureau result from the need to provide emergency treatment and for some more intensive hospital-based therapy following ingestion of material considered toxic by doctors and nurses working in hospitals and general practice.
The Poison Information Service is required to provide
answers to the thousands of inquiries each year, for patients who have ingested
substances of which the doctor supervising treatment has little or no
information regarding toxicity. The material ingested particularly by young
children are extremely varied and include anything found in the home e.g. for
domestic home decorating and many other materials which cause parents to seek
medical advice when consumed by children. A call to the center result from an accident
and are for advice on acute toxicity and appropriate treatment, the Poisons
Information Bureau must have data filed away for immediate reference purpose,
on thousands of materials that could be the cause of such inquiries. Unlike the
drug information center in a hospital pharmaceutical service, all inquiries
arrive by telephone and demand an immediate answer in the form of advice on the
toxicity of the product and appropriate treatment to be given to the patient.
They must provide continuous service 24 hours a day 7 days a week.
It is possible to divide the data required into broad
categories (e.g. chemical, plants and fungi, pharmaceuticals, agricultural and
horticultural products, household items, and cosmetics). When collecting the
information, the prime source is the product manufacturer, who can provide formulation data and in the
pharmaceutical industry is also often able to offer toxicity data. The majority
of the manufacturers are willing to provide details of the constituents of
their products when they realize, it is required to treat a patient. It is, however, always agreed by the
centers that any information, provided for the service will be treated in
strict confidence. The data-base of Poison Information Service is made up of
entries on thousands of individual products as well as general entries on toxic
materials which vary from the active constituents of many products (e.g.
alcohol, turpentine, aspirin, and
hypochlorite) the index invariably grows larger each year as new products are
introduced and the data on old products are retained since households can keep
items for many years before they are involved in an incident requiring help
from the Poison Information Bureau.
The method of storing data in the Poisons Information
Bureau should be standardized. The data
sheet format may be standardized and may include the following points of
information:
• Source: Synthetic – vegetable origin.
• Family (in the case of plants).
• Synonyms.
• Description.
• Habitat.
• Minimum lethal dose.
• Toxic effects.
• Symptoms.
• Pharmacodynamics.
• Treatments.
• Any other treatments (full supportive therapy).
• Prognosis.
• References.
The information included on treatment is obtained from
reference sources and suppliers with specialist information, e.g. drug
manufacturers from the toxicological investigations of their laboratories. The
pharmacists working in Poisons Information
Bureau need to maintain up-to-date knowledge of treatment methods by
continual scanning of the medical literature for published treatment details
and the results of alternative regimens. In some cases, precise advice cannot
be given because of the limited published data being available, it is useful in
those cases to follow up inquiries to the service and obtain details of the
outcome of treatment of the particular case.