Factors that trigger emergency physicians to contact a poison centre: findings from a Swiss study.

Schurter, David; Rauber-Lüthy, Christine; Jahns, Maximilian; Haberkern Schläpfer, Monika; Kupferschmidt, Hugo; Exadaktylos, Aristomenis; Eriksson, Urs; Ceschi, Alessandro (2014). Factors that trigger emergency physicians to contact a poison centre: findings from a Swiss study. Postgraduate medical journal, 90(1061), pp. 139-143. BMJ Publishing Group 10.1136/postgradmedj-2013-132242

[img] Text
139.full.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (220kB) | Request a copy

OBJECTIVE Poison centres offer rapid and comprehensive support for emergency physicians managing poisoned patients. This study investigates institutional, case-specific and poisoning-specific factors which influence the decision of emergency physicians to contact a poison centre. METHODS Retrospective, consecutive review of all poisoning-related admissions to the emergency departments (EDs) of a primary care hospital and a university hospital-based tertiary referral centre during 2007. Corresponding poison centre consultations were extracted from the poison centre database. Data were matched and analysed by logistic regression and generalised linear mixed models. RESULTS 545 poisonings were treated in the participating EDs (350 (64.2%) in the tertiary care centre, 195 (35.8%) in the primary care hospital). The poison centre was consulted in 62 (11.4%) cases (38 (61.3%) by the tertiary care centre and 24 (38.7%) by the primary care hospital). Factors significantly associated with poison centre consultation included gender (female vs male) (OR 2.99; 95% CI 1.69 to 5.29; p<0.001), number of ingested substances (>1 vs 1) (OR 2.84; 95% CI 1.65 to 4.9; p<0.001) and situation (accidental vs intentional) (OR 2.76; 95% CI 1.05 to 7.25; p=0.039). In contrast, age, medical history and hospital size did not influence poison centre consultation. Poison centre consultation was significantly higher during the week, and significantly less during night shifts. The poison centre was consulted significantly more when patients were admitted to intensive care units (OR 5.81; 95% CI 3.25 to 10.37; p<0.001). Asymptomatic and severe versus mild cases were associated with more frequent consultation (OR 4.48; 95% CI 1.78 to 11.26; p=0.001 and OR 2.76; 95% CI 1.42 to 5.38; p=0.003). CONCLUSIONS We found low rates of poison centre consultation by emergency physicians. It appears that intensive care unit admission and other factors reflecting either complexity or uncertainty of the clinical situation are the strongest predictors for poison centre consultation. Hospital size did not influence referral behaviour.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Haberkern Schläpfer, Monika and Exadaktylos, Aristomenis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0032-5473

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

22 Apr 2015 12:26

Last Modified:

23 Jan 2018 12:15

Publisher DOI:

10.1136/postgradmedj-2013-132242

PubMed ID:

24443557

Uncontrolled Keywords:

Accident & Emergency Medicine; Toxicology

BORIS DOI:

10.7892/boris.67026

URI:

https://boris.unibe.ch/id/eprint/67026

Actions (login required)

Edit item Edit item
Provide Feedback