Rotation 4- Poison Control-

Posted by E. Caliman at Friday, October 09, 2015

My fourth rotation was also at the Poison Control Center, so I had the same experience as Emily in the post below. I was also surprised that knowing the substance the patient took wasn't particularly critical to treating the patient; many times, you just treat the symptoms as they show up. It still made it interesting to guess the substance when we went over cases. I also learned that not every toxin has an antidote, which leads to treating the patient supportively.

Several of the cases involved acetaminophen (Tylenol) in some form, which is to be expected: it's the most common toxin called into poison control centers and the most common cause of liver failure. Alcohol was also very common, as well as a mixture of illicit substances. On the other hand, we got to handle uncommon cases, such as rattlesnake bites (the only rattlesnake in Michigan is the Massasauga), insulin, and fuzzy caterpillars (not poisonous, but the "fuzz" is actually many tiny spines, so it's like a porcupine). It was interesting to see how certain substances were more common to certain age groups. Another interesting point was that the patient may not be telling you the truth when they tell you what they took. Sometimes, what they say they took and what they actually took look completely different.

This rotation highlighted several things we discussed in the American Pharmacist Association's Generation Rx committee about securing your medications. Even though the focus of the committee is young adults getting into their parents or grandparent's medication cabinets, young children also can get access to them if they're not locked, get past child-resistant caps, and consume medications in spite of the taste. One of the cases I consulted for while on call involved a kid about 2 years old who took some of his parent's medications when they were briefly left unattended. Another problem highlighted was that of household products. Detergent pods are very colorful and appealing to children and their contents are under pressure. If a child bites one, some of the liquid detergent can spray to the back of the throat where it can be swallowed, or worse, inhaled. Chemicals found in the garage are also a problem. Products such as antifreeze and brake fluid have a sweet taste, but can cause renal failure, which means the patient may be put on hemodialysis for life.

Overall, this was a great rotation and I'm considering further studies in toxicology. If nothing else, I can expand my knowledge base to better help my patients.