Diagnosis in Emergency Room
Poisoning treated at Med Center
By JULIE THATCHER Kansan Staff Writer
Caution: Poison—a label not seen by a child who swallows his mother's cleaning solvent, or by an aged patient who mixes prescriptions and gets a violent reaction, or by the youth who takes an overdose of drugs to commit suicide.
These representative cases and hundreds more are treated each year at the University of Kansas Medical Center. One of more than 400 poison control and information centers in the United States, the emergency room of the medical center has resources, personnel and equipment available to handle the many potentially dangerous poisoning cases.
Dr. Roger L. Youmans, director of the emergency room and member of the poison control committee, said in a recent interview that more than 800,000 cases of poisoning occur each year in the United States and that poison control and information centers have been established to cope with this problem.
THE NATIONAL Clearinghouse for Poison Control Centers integrates the operations of the local organizations and provides comprehensive data on types of ingestions, directs a preventional education program and acts as a final source of information.
At the medical center, more than one poisoning case a day is handled by the emergency room staff. Youmans said. Many of these are, treated over the telephone, he said, and it is necessary for the resident in charge to immediately obtain six pieces of information.
Youmans said the information the staff needed to know was the name and age of the patient, the product ingested, the amount ingested and the time of ingestion.
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He said the most important fact to obtain was the caller's telephone number in case they were disconnected before the consultation was finished.
ONCE THE INFORMATION is available, he said, the doctor consults the reference materials located in the emergency treatment area.
The primary source in the emergency room is a card file with 3,000 products listed alphabetically. Youmans explained. Each card tells the ingredients, symptoms and treatment of the product. The National Clearing-house updates 15 to 20 cards every month, he said.
There is also a "Physician's Desk Reference" which lists 95 per cent of the prescription drugs, Youmans said. "Gleason's Clinical Toxicology of Commercial Products" lists an additional 50,000 commercial products, he said, and another book has life-size, color photographs for sight identification of drugs.
IF THESE SOURCES are not sufficient, Youmans said, two toxicology specialists are available for consultation and rare problems can be referred to the National Clearinghouse in Washington.
Youmans said patients who were brought to the emergency room, were treated in one of three ways. If the ingestion occurred within the previous four hours, he said, the stomach is pumped empty. Otherwise an attempt is made to neutralize the toxic substance or eliminate it by increasing kidney action.
If the drug is unknown, he said, then the doctor treats the symptoms as they occur. He added that the sooner treatment began, the less serious the results.
BECAUSE THERE are more than 500,000 commercial products that could be toxic, John Doull, toxicologist and chairman of the poison control committee, said
prevention was the most important method of treating poisoning.
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"There are a quarter of a million household products with a real degree of hazard," Doull said, "and people don't think of them as poison."
He listed insecticides, lawn care, automobile care and cleaning products as examples. Nationally, aspirin accounts for one third of poisoning cases and cleaning and polishing agents contribute sizeably, he said.
Dould said there had been an immense effort to educate parents. A two-year-old is immensely curious, he said, and there is an oral curiosity with everything going into the mouth.
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areas for improvement. He said he would like to see intensive care areas and a computerized toxic information center developed.
ter are children under five, Youmans said. To prevent this high incidence rate, Youmans said parents should keep dangerous substances out of children's reach, they should never transfer products to substitute containers such as a coca cola bottle and they should never talk about medicine as candy.
MORE THAN 70 per cent of the cases treated at the medical cen-
Doull said there were several reported cases of poisoning involving green iron tablets that looked very similar to candy M & Ms. Moth balls used to be a major contributor to poisonings.
Although there have been improvements by commercial firms, including new bottles, limits on the number of tablets per bottle and strip packaging, Doul said he thought there were two more
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