At supper time on a recent Tuesday, a call came into the Southeast Texas Poison Center. A worried father had just learned his sons, 6 and 9, had eaten a pack of 4-day-old chicken nuggets.
While impossible to determine contamination by phone, the center’s consultant told him when food poisoning, if it occurred, would set in, what to do and when to go to the emergency room.
Tucked away above the emergency room on the campus of UTMB, the center has been offering calm counsel for 50 years. The staff of experts provides assistance 24 hours a day at no charge.
“Nothing is really routine,” center director Jon Thompson said. “Each phone encounter is a special event.”
From panicked parents to paramedics on the scene, the center handles an average of 250 calls per day. More than half the calls involve children age 5 and younger, and most of those are about toddlers 2 and younger. Calls peak in the evening as parental distractions, such as answering the door or cooking dinner, reduce vigilance.
From opening childproof caps and cupboards, to finding a way to scale cabinets, young children can get into poison in an instant.
“Callers often say they only turned their eyes away for a second, and that’s all it takes,” Thompson said. “Toddlers are ingenious and energetic. They’re fearless.”
In a best-case scenario, the center’s advice can prevent a trip to the emergency room. They’re successful almost 75 percent of the time, and that saves a lot of money.
Studies have shown every dollar invested on poison control saves at least $7 to $9 in health care costs associated with unnecessary emergency room visits and transport. That is a saving of nearly $20 million for this center alone. Beyond savings, they might spare a child the stress of a trip to the emergency room.
About 20 percent of calls come from health professionals: a pediatrician’s office, an emergency room or a paramedic needing information in the field.
“We see things every month that a doctor or nurse may not have seen in some time, if at all,” Thompson said.
He cited the case of two children who showed up at an emergency room having eaten a putty-like substance they thought was fudge. A consultant tracked down the coding on the packaging, which led to the Department of Defense and the information that the “fudge” was a plastic explosive. As it turned out, the substance was not toxic when ingested.
“There’s never a dull moment,” Thompson said. “You never know what the next call will bring.”
Poison centers started to develop in the early 1950s as a result of an increase in accidental poisonings of children from medications. Pharmacists were the first line of defense, and a red phone installed in the the medical branch pharmacy was the state’s first poison control hotline.
Through time, Texas developed the Texas Poison Center Network of six integrated centers that are linked to a national association of poison control centers.
The center covers 28 counties from Nacogdoches to the Gulf of Mexico, and from the Louisiana border to just east of Victoria. The other centers are in Dallas, Amarillo, El Paso, San Antonio and Temple. Texas has more centers than any other state and, though not every state has one, all states are linked to the national network.
A computer monitor in the center allows those on duty to know the status of their colleagues throughout the state. If a call cannot be answered within 10 seconds at the target regional poison center, the telecommunications network connects it to another center in Texas.
By the numbers
Southeast Texas Poison Center operates 24 hours a day, seven days a week at 1-800-222-1222.
Of the 250 calls the center receives on an average day:
- 54 percent involve children 5 and younger;
- 42 percent involve children 2 and younger;
- 72 percent of calls are managed on-site at home, school or work with advice or consultation;
- 20 percent of calls come from health professionals: doctor’s offices, emergency rooms or paramedics/EMS on scene; and
- Every $1 spent on poison control support equals $7 to $9 saved in unnecessary treatment costs.
A diverted call will be referred back to the original target center when appropriate.
Texans are better served by having centers that address the specific needs of each region. Consultants are experts in their region’s medical infrastructure and can direct a caller to the nearest emergency room or to another location that has the resources to deal with the problem.
“We are the go-to center for things marine,” Thompson said.
They provide help for everything from jellyfish stings to encounters with stingrays. For example, a young man who had visited his mother in Galveston grew ill on returning home to Minnesota, and doctors were puzzled by his symptoms.
His hands felt hot under cold water, and cold under hot water. His mother’s call to the center identified the problem as ciguatera poisoning from eating fish. The toxin results from algae bloom that concentrates in larger fish, such as barracuda and grouper.
There are seasonal events and rhythms for which the center can predict and prepare. In the aftermath of a hurricane, for instance, there will be an increase in calls about accidental gasoline ingestion, carbon monoxide poisoning from poorly ventilated generators and, within a couple of days, food poisoning.
Often there can be serious problems as products come to the marketplace. Thompson noted a fuel for tiki torches was introduced that came in a jug and was apple-scented and easily mistaken for apple juice.
Since 9/11, the staff has received specialized training to respond to chemical, biological, radiological and nuclear events.
Fortunately, the increase in potential poisonings has been matched by improved technology. Today, a call regarding a mushroom ingestion or snakebite might involve sending a cell phone picture to confirm its poisonous status.
“Technology has made our job easier in that sense,” Thompson said.
Technology also enables poison centers to act as a sentinel. Information on the type of call and the caller’s ZIP code is entered into a database. A spike in calls with similar symptoms coming from a particular ZIP code can provide an early warning to a greater problem.
In a chemical release, they might get calls about unusual smells or headaches and nausea. When the Space Shuttle Columbia disintegrated over East Texas, the center began getting calls almost within minutes from people reporting falling debris and worrying about possible toxic effects.
Thus, fallout locations could be determined and plotted, and local residents and emergency responders alerted to dangers.
While providing immediate help, each center also has an educator who does community outreach. The most familiar example of this is the bright green “Mr. Yuk” sticker, freely dispensed to label anything poisonous.
The center also offers handouts on common dangers, such as snakes and plants, which also are available in Spanish.
Thompson knows the calls will keep coming, despite their best efforts.
“There are too many kids and too many chemicals.” When they come in, the center will be there to help.
“We know a lot but we don’t know everything,” Thompson said. “However, we do know how to find out the answers.”