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Poison Control Reports Help ED Physicians Keep Up with Latest Dangers

DENVER – Most emergency physicians know that bath salts aren’t only something to pour into a tub for a relaxing soak or that plant food isn’t just a way to provide nutrients to begonias.

ED care providers have to keep up with illicit street drugs such as “bath salts,” “plant food,” and synthetic marijuana – as well as seemingly harmless grocery store products like laundry detergent pods to know what agents are likely to poison patients, according to the author of a report from the National Poison Control Center. The study, “Poisoning in the United States: 2012 Emergency Medicine Report of the National Poison Data System,” was published online recently in Annals of Emergency Medicine.

"The poison center system can provide real-time advice and collect data regarding a variety of poisonings, including those that may be new or unfamiliar to emergency physicians," said lead study author Richard Dart, MD, PhD, of the Rocky Mountain Poison and Drug Center in Denver. "Emergency physicians are continually challenged by the emergence of new types of poisonings, which lately include illicit street drugs as well as laundry detergent pods.”

Dart noted that the National Poison Data System (NPDS) plays an integral role in helping EMS and emergency departments respond to the dangerous substances.

In 2012, poison centers across the country recorded 2.2 million human poison exposures, although the vast majority are managed without patients having to show up at EDs. The need to go to a medical facility for poisonings increases with patient age, however: In 2012, 11.6% of children under 5, 14% of children age 6 to 12, 51.2% of teenagers and 37.9% of adults were treated in a health care facility for poisonings.

By far, the most common cause of poisoning, 83%, were from pharmaceutical products, especially opioid painkillers although the report also included cardiovascular and antidepressant medications. Prescription opioid exposures by children more than doubled between 2002 and 2012 from 2,591 to 5,541. Carbon monoxide was the leading non-pharmaceutical agent leading to poisoning deaths, according to the review.

While generally not life-threatening, laundry detergent pods emerged in 2012 as a new source of pediatric poisoning, according to the report. In 2013, poison centers received reports of 10,395 exposures to highly concentrated packets of laundry detergent by children 5 and younger, according to the American Association of Poison Control Centers.

Also increasingly dangerous are designer drugs such as bath salts, plant food and synthetic marijuana, which can poison users severely enough to require emergency medical treatment. Everything from seizures to psychotic episodes has been reported. While bath salts exposures peaked in 2011, new illicit drugs sold to consumers are constantly monitored by poison control centers, according to the report.

"Poisoning continues to be a significant cause of injury and death in the United States," Dart said. "The near real-time responsiveness of NPDS helps emergency physicians respond to new poisoning threats, while also assisting patients who call for help to know when they need the ER and when they can manage things safely at home."