Poisons centres
What is a poisons centre?
A poisons centre is a specialized unit that advises on, or assists with, the prevention, diagnosis and management of poisoning. The structure and function of poisons centres varies around the world. At a minimum a poisons centre is an information service. Some poisons centres may also include a toxicology laboratory and/or a clinical treatment unit.
What does a poisons centre do?
A poisons centre provides an emergency poisons information service. It may also provide an analytical toxicology service and a clinical service. In addition the poisons centre may play an important role in developing contingency plans for, and responding to, chemical disasters, and may be involved in monitoring the adverse effects of drugs, and in handling problems of substance abuse. It may also be involved in research, education and training.
Poisons Information Service
The poisons information service is concerned with the risk assessment, diagnosis, management and prevention of exposure to any substance, by any route, in patients of any age, and arising from any circumstance, be it accidental, intentional, occupational etc. In addition the poisons centre can provide general information about substances, their properties and toxicity.
All poisons centres deal with enquiries by telephone, most will also answer written enquiries, and some deal with enquirers face-to-face. Telephone enquiries concerning acute poisoning or suspected poisoning are usually answered urgently. Ideally the telephone information service should be provided on a 24 hour basis, although in some centres resources do not permit this and the hours of operation are shorter.
This service may be provided to the general public or may be restricted to health professionals. Other users of the centre may include the emergency services, government ministries, regulatory agencies, education services and others.
Usually, someone will contact the poisons centre because they have a patient or a family member who they think has been exposed to a toxic substance. The role of the poisons centre is to take the history from the caller and then to advise the caller whether there is a risk of poisoning, or whether the patient is in fact showing clear signs of poisoning, and what, if any, action needs to be taken. The poisons centre can provide information about the toxicity of the substance concerned, the toxic effects and the treatment required.
To be able to answer these enquiries the poisons centre needs to maintain a comprehensive collection of information about chemicals, pharmaceuticals, products, plants and venomous animals. The centre also needs to develop treatment protocols and guidelines in order to ensure that the information and advice given is consistent.
The staff of the poisons centre are usually physicians, nurses, scientists, pharmacists or a mixture of these. This depends very much on local circumstances.
Analytical toxicology service
Some poisons centres include a specialist laboratory that provides an analytical toxicology service. Such a service can assist with the diagnosis, assessment and treatment of poisoning. Analyses may be carried out on both biological and non-biological samples, e.g. blood, urine, hair, nails or scene residues in order to identify and quantify toxic substances. In some cases analyses may be required urgently to determine the appropriate management of, for example, paracetamol (acetominophen), iron or methanol poisoning. For other kinds of poisoning less urgent analytical confirmation is required.
More information
- Guidelines for poison control (in English)
- Guidelines for poison control (in French)
- Guidelines for poison control (in Spanish)
Clinical service
Some poisons centres include a clinical unit for the treatment of poisoned patients. Patients may be transferred to this unit from surrounding hospitals.
