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Background: 'Drug Imprinting' was first implemented by Eli Lilly and Company in 1962 for all its products. The state of Washington mandated the use of imprints on all prescription drugs in 1980 and for 'OTCs' in 1991. The FDA implemented federal requirements in 1995. Unfortunately, the FDA permitted the continued use of symbols, logotypes, and trademarks as code components, limiting the use of automated recognition systems, which we demonstrated in both 1992 and 1995. In December 1999, we sought a measure of our success in responding to phone inquiries seeking decoding of imprints. Method: Analyses of several week-long samples of phone inquiries were conducted, documenting imprinting calls, the staff's ability to respond with an identification, the information sources used, and the apparent reasons for any failure. Results: Surprisingly, in our first week's sample, we received a total of 666 decoding requests, which--projected for the year--amounted to more than 25,000 annual calls. A review of 1999 total data confirmed we had exceeded that number. Staff was able to reach an identification in 93.8%. Both uninterpretable symbols and absence of code listings contributed to the 36 failures. Conclusion: While we were pleased to achieve a greater than 90% success rate, we were overwhelmed by the number of inquiries and repeated our study on several subsequent week samples. Projecting our findings and our penetrance to the rest of the United States would suggest as many as 1.25 million possible calls costing poison centers as much as $25 million per year. Using either a touch-tone telephone or website response system could permit a totally automated response with enormous reduction in human costs. Neither solution is feasible absent elimination of symbols or logotypes, so as to permit an exclusively alpha-numeric code. Efforts are underway to achieve same., Marder S, Winkler T, Tadaki K, Bobbink S, Robertson WO. Washington Poison Center, Seattle, [...]

Objective: To determine a simple and cost-effective way for a regional poison center's public education department to reach a state population with information concerning National Poison Prevention Week and year-round poison center services. Method: We designed four bookmarks each with a different poison prevention message. At the beginning of February we distributed 200 bookmarks, along with one National Poison Prevention Week poster to each public library in the state. In early May we mailed each library a questionnaire to (1) determine how many distributed and posted our materials, and (2) obtain feedback on the librarians' perceptions of the project's effectiveness. Results: Fifty-one percent (167) of 326 libraries responded to our questionnaire. Of the respondents, 94% (157) reported the bookmarks had been distributed to patrons during National Poison Prevention Week. Ninety-one percent (153) felt the bookmarks were an effective way of letting people know about both the poison center and National Poison Prevention Week. Forty-three percent (72) thought too many bookmarks had been mailed. Forty-four percent (74) thought the number of bookmarks had been sufficient and 8% (14) thought the number had been too small. Sixty-three percent (106) had displayed the poster on one of their bulletin boards and 28% (47) had not. Ninety-seven percent (163) noted that they would like to receive similar materials in the future and 3% (4) indicated they would not. Based on our daily statistics, there had been an actual increase in the number of calls to the poison center during the month of March, including more than the expected number of requests to our public education department for materials and information. Conclusion: Distribution of bookmarks via the public library system appeared to be a successful way to both educate and inform the public about National Poison Prevention Week and the availability of our statewide poison center and its services., Cropley J, Gibson J, Christoff D, Bobbink S, Robertson WO. Washington Poison Center, Seattle, [...]

Background: Poison Centers (PCs) throughout the country have developed plans for continuation of service to their region in the event of a disaster by sharing and/or consolidating resources with other PCs. We present implementation of a disaster plan which allowed a population of 4.5 million within 3 states to be served by 5 alternative PCs for 2months during a labor dispute. Methods: The requirements of a disaster plan for a potential work stoppage included: ability to implement the plan within 1 hour of final notification, call routing to maintain consistency of caller access to the same PC, and the ability to distribute calls among 5 centers according to ability of each to handle additional call volume. Regional resources, health care facility/agency contacts and open case data were distributed to facilitate consistent, comprehensive case management by the alternative centers. Results: Incoming calls to the PC originate from 7 different phone numbers managed by 3 separate telecommunications services. A telephone routing plan was developed based on availability of routing mechanisms for each phone number and the additional call volume capacity of each alternative PC. The institutional phone switch of the PC allowed internal call routing of any additional calls terminating on a local line within the center. The alternative PCs provided ongoing evaluation of call activity to facilitate early identification and resolution of concerns. Medical and administrative staff of the PC maintained continuous contact with the alternative PCs to assist with case management and regional resource utilization. Conclusions: Detailed analysis of call volume from all sources, advanced call routing strategies and the ability to mobilize necessary resources can facilitate alternative call handling in the event of a disaster., Giffin S., Heard S, Bobbink S. Oregon Poison Center, Oregon Health & Science University, Portland, OR California Poison System, San Francisco, CA Washington Poison Center, Seattle, [...]