Drug identification: a survey of poison control centers.

Abstract

The objective of this study was to determine current practices and opinions of poison center staff and directors regarding drug identification (ID) calls. Surveys were developed and mailed to 911 poison center staff members and 69 managing directors at 69 poison control centers in the United States in December 2001. Responses were received from 317 staff members and 33 directors from 49 centers. Nearly half of the staff respondents stated that they had not received drug ID training beyond how to look up the identity of an oral medication. About one-half of staff and director respondents stated that their centers had only informal (unwritten) drug ID policies, while one-fourth each responded they had formal written policies or had no policy at all. A majority of respondents indicated that their centers either allow or require specialists to provide ID for non-ingestion-related cases. Nearly all staff and director respondents routinely provide ID services to law enforcement officers and health care professionals regardless of whether ingestion was involved. Slightly more than one-half of staff respondents inquire about possible ingestion with almost every request, while one-third only inquire when the caller gives some indication that ingestion may have occurred. Case-based questions reveal that different practices are utilized depending on the type of medication for which ID is being requested. Factors such as risk of liability, patient confidentiality, guardianship, and the person's best interest appear to contribute to decisions regarding the provision of medication ID. Drug identification practices vary from center to center throughout the United States. Though the service is greatly utilized, few centers have written policies. In addition, training for the provision of this service appears to be inadequate in many centers. The development of drug identification guidelines to be utilized throughout poison centers would provide much needed consistency and guidance.