POISINDEX© is an excellent source of toxicological information. This resource can provide you with information on ingredients contained in a product, clinical effects associated with exposure to a product and their management. POISINDEX© lacks the ability to interpret lab and physical exam parameters, which are customarily used to adjust therapy to the specific needs of the patient. It also does not help in the interpretation of synergistic or antagonistic effects resulting from exposure to multiple agents. Poison control center staff and toxicologists handle approximately 150-200 toxic exposure cases per day and have developed an expertise in this area to assist you in making diagnostic and therapeutic decisions.
At the national level, there are currently 54 poison control centers in the U.S. that are accredited by the American Association of Poison Control Centers, the national agency which certifies poison control centers based on standardized criteria. Accredited poison control centers maintain a baseline standard of practice. Some centers provide advanced services relating to education, on-call services, quality improvement, research, industry partnerships, etc. We promote the policy of “getting to know your poison control center” and invite all practitioners who utilize our services to visit their nearest center.
Specialists in Poison Information (SPIs), those individuals who provide the first line of care in our system, can be pharmacists, nurses, physicians or physician’s assistants. Once hired, each new SPI is given approximately 40 hours of study and six months of supervised clinical training. During the training period, every case handled by the new SPI is reviewed. Training programs are customized and geared toward individual needs. A board certified toxicologist is available 24 hours a day to discuss cases, if the need arises. At the end of 2,000 hours of experience and the successful handling of 2,000 cases, the SPI becomes eligible to take the national SPI certification examination administered by the American Association of Poison Control Centers (AAPCC). The SPI must pass this examination within three years of hire to continue to work in our centers. The successful completion of the examination confers the title of Certified Specialist in Poison Information, or CSPI. The CSPI must undergo re-certification by re-examination every seven years. By AAPCC accreditation criteria, the managing director must be board eligible or board certified in toxicology by the American Board of Applied Toxicology (ABAT) for non-physicians, or the American College of Medical Toxicology (ACMT) or its predecessor (the American Board of Medical Toxicology [ABMT]) for physicians. The Poison Control Center medical director must also be board certified by one of the above agencies for physicians, or be grandfathered in under specific criteria. The Florida Poison Information Center Network (FPICN) utilizes clinically active board certified toxicologists accredited by the American College of Medical Toxicology (ACMT) or American Board of Applied Toxicology (ABAT).
There are a couple of different board certification routes in clinical/medical toxicology. The sub-specialty boards of the American Board of Emergency Medicine (ABEM), the American Board of Preventive Medicine (ABPM), or the American Board of Pediatrics (ABP) give exams for physicians with a background in toxicology. Criteria to sit for the examination vary among these groups. The American College of Medical Toxicology (ACMT) is a professional, nonprofit association of physicians with recognized expertise in medical toxicology. The College is dedicated to advancing the science and practice of medical toxicology through a variety of activities. For physicians in practice prior to 1992, board certification was possible upon passing an examination with proof of adequate prior field experience. Since 1993, the American College of Medical Toxicology (ACMT) has administered a certification exam to physicians who successfully complete an ACGME-accredited, two-year fellowship program. The American Board of Applied Toxicology (ABAT) (under its parent organization, the American Academy of Clinical Toxicology [AACT]) administers a board certification examination in clinical toxicology for non-physicians. To credential for this examination, a non-physician must be a graduate of a college with a doctoral degree in a biomedical discipline. Applicants for Diplomat status in ABAT without doctoral degrees must possess a baccalaureate degree in a health science discipline, such as pharmacy or nursing, followed by a minimum of five years of full-time professional experience in applied clinical toxicology. The ABAT exam requires a credentialing process prior to examination to evaluate each applicant in the areas of clinical, research, teaching and leadership in the field of toxicology. Twelve months of post-doctoral fellowship or three years of toxicology experience are required. Upon successful completion of the credentialing and examination process, an applicant is awarded designation as a Diplomat of the American Board of Applied Toxicology (DABAT).
The poison control center staff will provide assessment, triage, management and monitoring recommendations. Detailed information on antidote use, monitoring and availability are also part of our services. We can help with identification of the animal, plant, insect or tablet involved in a case. By calling your local poison control center, you have access to a board certified toxicologist, 24 hours per day for consultation. We track incidence of poisonings and can share trends occurring in your area. We can also provide digital and in-person educational programs. These services are offered free of charge.
Poison control center educators provide poison prevention awareness programs throughout the state of Florida and the U.S. Virgin Islands. These programs, which are geared toward various age groups, are the foundation for poison prevention efforts in our quest to reduce the incidence of accidental poisonings. Our educators use interactive lectures, health fair exhibitions, visits to schools and web-based learning tools to reach people across the state. Since Florida’s poison control centers manage more than 80% of residential callers at home without the need for a health care facility visit, awareness of poison control center capabilities lead to more effective use of health care resources and significant cost savings for individuals and tax payers.
According to Florida statutes relating to the Florida Poison Information Center Network, each of the poison control centers in Florida must be located at a Level I Trauma center and must also be affiliated with a College of Medicine or Pharmacy. The Florida/USVI Poison Information Center – Jacksonville is located on the campus of UF Health Jacksonville/University of Florida Health and is affiliated with the University of Florida College of Medicine. The Florida Poison Information Center – Miami is located on the campus of the University of Miami Miller School of Medicine and Jackson Health System. The Florida Poison Information Center – Tampa is located on the campus of Tampa General Hospital.
Funding for poison control centers in the U.S. has included a patchwork of monetary pathways to provide services for which specific institutions cannot bill or afford to totally underwrite. The Florida Poison Information Center Network is principally funded by the State of Florida Department of Health through direct contracts with Children’s Medical Services (CMS). The centers also receive federal grant funds through the Health Resources and Services Administration (HRSA) to support ongoing services and promote growth. Finally, each poison control center receives in-kind support from its host institution, and both direct and/or in-kind donations from our community at large.