Certified as a Regional Poison Center by the American Association of Poison Control Centers. Go to Table of Contents

Transcription

1 Certified as a Regional Poison Center by the American Association of Poison Control Centers Go to Table of Contents

2 WVPC Annual Report 2015 Table of Contents ABOUT US Our Mission Statement History Who we serve Types of calls managed Resources utilized Data Collection STAFF & CONTACT INFORMATION Our Contact Information WVPC Administration & Staff Advisory Board FINANCES Funding Program Expenses Dollars Saved MEMBER TREATMENT HOSPITAL PROGRAM Description & Member Hospitals COMMUNITY OUTREACH Activities National Poison Prevention Week Website PROFESSIONAL OUTREACH Professional Education Committee Representations DATA Call Volume/Types Reason for Exposures Caller Site Treatment Site Route of Exposure Age & Sex Distribution Top 10 Drug Exposures Top 10 Non Drug Exposures Medical Outcomes Hospital Call Statistics County Call Statistics WV County Penetrance Map Substance Categories Data (Drug) Substance Categories Data (Non Drug) PUBLIC HEALTH & HAZARDOUS MATERIALS Public Health Information & Data Naloxone Tracking and Assistance Hazardous Materials Operations WVPC s UNIFYING THEME

3 The West Virginia Poison Center is an information resource for both the public and health care professionals, whose two fold purpose is to assist in the provision of optimal treatment of the poisoned patient and to reduce the number of accidental poisonings throughout all fifty five counties of West Virginia.

4 History Established in 1979 by then WV Governor, U.S. Senator Jay Rockefeller Recognized by the State of West Virginia as West Virginia s only poison center - April 1986 Established in WV Code W. Va. Code 18B-11B-1 et seq. (HB 4651) st certification as a Regional Poison Center - September 1986 Re-certification granted: 1992, 1997, 2002, 2007, 2012 Moved from borrowed space to the Robert C. Byrd Health Sciences Center, West Virginia University Charleston Division 1993

5 Those Served by the WVPC: General public Health care professionals All ages (infants, children, adolescents, adults, senior citizens) All socioeconomic classes (rich, middle class, poor) All facilities (home, hospitals, schools, businesses, industry) All 55 counties in West Virginia Hours of Operation: 24 hours a day (toll free number available, and TTY accessible) 365 days a year

6 Types of Calls Managed: Accidental poisonings in children & adults: Medications, plants, mushrooms, household cleaners, etc. Misuse of drugs or chemicals Drug interactions/adverse reactions Self harm/suicide attempts Substance abuse toxicity (opioids (e.g., hydrocodone, heroin), synthetic drugs of abuse, cocaine, LSD, any type) Spider, snake, and insect bites Hazardous material exposures (e.g., chemical spills, terrorism agents) Occupational exposure to chemicals Chronic lead poisoning Poisonings in pets (triage)

7 Resources Utilized: Trained and experienced medical experts Computer databases On-line databases An up-to-date comprehensive toxicology library Primary literature (updated weekly) Specialty consultants Internet Material Safety Data Sheets (MSDS s) Language Line

8 Data Collection The WVPC participates in the American Association of Poison Control Center s National Poison Data System (NPDS); the largest poison exposure data base in the United States Data collected is used to: Target problem areas and adjust services Advance knowledge of poisons and antidotes Teach health care professionals and students Provide necessary data for product safety regulation

9 West Virginia Poison Center Robert C. Byrd Health Sciences Center-Charleston Division (304) Administration (304) Community Outreach Coordinator/Prevention Education Web Site: Emergency Service-Statewide (TTY accessible) The West Virginia Poison Center is a service of the West Virginia University Health Sciences Center Charleston Division. The WVPC is academically affiliated with the West Virginia University School of Pharmacy.

10 West Virginia Poison Center Staff January 1, 2015-December 31, 2015 Director: Elizabeth J. Scharman, Pharm.D., DABAT*, BCPS**, FAACT` Professor, WVU School of Pharmacy, Dept. of Clinical Pharmacy Medical Director: Back-up Medical Directors: Anthony F. Pizon, M.D., ABMT^, ABEM^^ Michael Lynch, M.D., ABMT^, Michael Abesamis, M.D., ABMT^, Nathan Menke, M.D., ABMT^ (until June 30) Joseph Yanta, MD (from July 1) Supervisor of Operations: Jamie R. Cook, BSN, RN, MSN, CSPI #, AHLS ## Logistics Supervisor: Ryan S. Aliff, RN, BSN, CSPI #, AHLS ## (through June 25, 2013) Specialists in Poison Information: Sue A. Acord, BSN, RN, CSPI # Pamela J. Chase, RN, CSPI # Nicole D. Clendenin, BSN, RN, SPI Willette K. Haught, RN, CSPI # Community Outreach Coordinator: Administrative Assistant: Kenneth G. Haught, BSN, RN, CSPI # Britney L. (Harper) Hill, BSN, RN, SPI Carissa E. B. McBurney, MPA Monique Sypolt, BA *Diplomate: American Board of Applied Toxicology **Board Certified Pharmacotherapy Specialist `Fellow, American Academy of Clinical Toxicology ^American Board Medical Toxicology ^^ American Board Emergency Medicine +Fellow American Academy Emergency Medicine #Certified Specialist in Poison Information ##Advanced Hazmat Life Support See Photo Section

11 West Virginia Poison Center Staff Dr. Elizabeth Scharman, Pharm.D., DABAT, BCPS, FAACT; Director Jamie Cook, RN, MSN, CSPI, AHLS; Supervisor of Operations Ryan Aliff, RN, BSN, CSPI AHLS; Logistics Supervisor Monique Sypolt, BA; Administrative Assistant Dr. Tony Pizon, M.D., ABMT; Lead Medical Director Carissa McBurney, MPA; Community Outreach Coordinator

12 WV Poison Center Poison Specialists 2 Poison Specialists not pictured

13 WV Poison Center Poison Clinical and Medical Direction Dr. Elizabeth Scharman, Pharm.D., DABAT, BCPS, FAACT; Director Dr. Lynch, MD, ABMT; Dr. Pizon, MD, ABMT; Dr. Abesamis, MD, ABMT; Dr. Menke, MD ABMT The Lead Medical Director, Dr. Pizon (2 nd from left), and the back up Medical Directors, are all board certified medical toxicologists who also are board certified in emergency medicine. The clinical and medical directors are responsible for ensuring that: There is 24 hour a day availability of clinical and medical toxicology consultative services for health care professionals and WVPC Poison Specialists. All recommendations provided by the WVPC are based on the best, current, evidence based practice Health care professional education in clinical/medical toxicology in WV is provided Dr. Joseph Yanta, MD Maintaining an active emergency department medical practice is an important component of medical director qualifications for a Poison Center.

14 West Virginia Poison Center Advisory Board West Virginia University HSC, Charleston Division: John C. Linton, Ph.D., ABPP, Chair Office of Military Affairs and Public Safety: Cabinet Secretary Joseph Thornton Designee: West Virginia Higher Education Policy: Designee: West Virginia Bureau for Public Health: Designee: West Virginia Hospital Association: Designee: Health Care Representatives: Christine Morris, Deputy Secretary Paul Hill Ph.D., Chancellor Laura Boone, Esq:, Program Coordinator Rahul Gupta, M.D. Jerry Rhodes; Director; WV Center for Threat Preparedness Joe Letnaunchyn, President and CEO Samantha Stamper Letitia Tierney, M.D., J.D. Cabin Creek Health Clinic Teresa Calhoun, RN, MSN, CS-FNP Bayer CropScience General Public Representative: Ex-Officio (Director WVPC): Jack A. Rogers, Esq. Elizabeth J. Scharman, Pharm.D., DABAT, BCPS

15 Funding Sources Direct Costs 9% 18% 5% 68% WV Legislature WVU Health Sciences Outside Sources* Federal Funding *Member Treatment Hospitals, Donations, Grants Indirect costs and Director s salary covered by WVU Health Sciences not included in this chart

16 Program Expenses Direct Costs Salaries 84.0% Office Supplies, Databases, Software, & Educational 9.1% Materials Emergency Toll Free Lines/Telecommunications 3.8% Capitol Equipment, Information Technology Support, 1.7% & Maintenance Travel 1.4% Not included in the above direct costs: WVU Health Sciences Center Charleston Division covers indirect expenses (e.g., space, facility expenses, insurance) valued at $ 165, WVU School of Pharmacy covers the salary of WVPC Director who is a full time faculty member of the School.

17 DOLLARS SAVED IN WEST VIRGINIA = minimum $ 30 million WV Poison Center helps decrease: Unnecessary emergency department self-referrals Use of unnecessary ambulance services Use of unnecessary therapies Revenue for Direct Costs (State FY 15 16): WV Legislature: $ 702, ($ 55, mid year reduction) Federal Grant and Phone Support: $ 91, Member Treatment Hospitals: $ 131, Grants/donations/other: $ 51,655.00

18 MEMBER TREATMENT HOSPITAL (MTH) PROGRAM The West Virginia Poison Center s (WVPC) Member Treatment Hospital (MTH) Program is designed to extend the services of the WVPC into local communities throughout West Virginia. The WVPC provides Member Hospitals with: 1) Current information for poisoned patient management, and 2) Tools to educate local communities about the Poison Center and poison prevention. This cooperative effort is mutually beneficial to the patient, community, and the WVPC. The goal of the MTH program is to provide the most current and accurate poisoning management information to all hospitals in West Virginia in the most efficient manner possible. With the MTH program, hospitals in West Virginia pay a yearly fee to the WVPC in exchange for: 1) supplies of educational materials and Mr. Yuk stickers free of charge; 2) customized Toxic Substance Reviews; 3) WVPC attendance at health fairs; 4) WVPC participation at a hospital in-services upon request; 5) Availability of a free toxicology continuing education program for nurses, pharmacists, physicians 6) 24 hour availability of the WVPC s medical director; and 7) recognition as a contributor to the WVPC on the website (with hospital links) and annual report. Toxic Substance Reviews (TSR s), written by the WVPC staff, provide hard copy information about toxic substances. These reviews are transmitted upon request to the treating physician via facsimile (fax). This hard copy information is intended to supplement verbal information given by the Specialist in Poison Information. The WVPC remains in close contact with the hospital to follow the patient s progress and to provide further assistance as needed. Hospitals that choose not to participate in the MTH program are charged on a per call basis to cover the costs associated with providing written information.

19 MEMBER TREATMENT HOSPITAL (MTH) PROGRAM PARTICIPANTS Beckley Appalachian Regional Healthcare Berkley Medical Center Bluefield Regional Medical Center Boone Memorial Braxton County Broaddus Hospital Cabell Huntington Camden Clark Medical Center Charleston Area Medical Center (CAMC): -General -Memorial, -Women & Children s -Teays Valley Davis Memorial Fairmont General Grafton City Hospital Grant Memorial Greenbrier Valley Medical Center Hampshire Memorial Jackson General Jefferson Medical Center Logan Regional Medical Center Minnie Hamilton Heath Systems Monongalia General Montgomery General Ohio Valley Medical Center Beckley Martinsburg Bluefield Madison Gassaway Philippi Huntington Parkersburg Charleston Charleston Charleston Hurricane Elkins Fairmont Grafton Petersburg Ronceverte Romney Ripley Ranson Logan Grantsville Morgantown Montgomery Wheeling Plateau Medical Pleasant Valley Pocahontas Memorial Potomac Memorial Preston Memorial Princeton Community Raleigh General Reynolds Memorial Roane General St. Francis Hospital St. Joseph s Buckhannon St. Mary s Hospital Stonewall Jackson Summers County ARH Summersville Regional Medical Center Thomas Memorial Hospital United Hospital Center VA Medical Center Huntington War Memorial Hospital, Inc Welch Community Hospital Wetzel County Wheeling Hospital Williamson Memorial WV University Hospitals, Inc. Oak Hill Pt. Pleasant Marlinton Keyser Kingwood Princeton Beckley Glen Dale Spencer Charleston Buckhannon Huntington Weston Hinton Summersville South Charleston Clarksburg Huntington Berkeley Springs Welch New Martinsville Wheeling Williamson Morgantown

20 Community Outreach Poison prevention awareness programs for adults, children and medical professionals Poison prevention and WVPC awareness messages are provided via: volunteer program website presentations school programs health fairs newsletters press releases brochures Mr. Yuk stickers poison prevention week train the trainer flyers Programs and materials are provided to: daycare centers schools clinics physician offices hospitals families/individuals professionals communities senior centers See next page

21 Public Education Activities Poison Prevention Awareness in all 55 West Virginia counties throughout 2015 Distributed over pieces of poison prevention/wvpc awareness materials Teachers in all 55 West Virginia counties received WVPC information Highlights include: Community Baby Showers, WV Birth to Three Train the Trainer Webinar, Back to School Bashes, school presentations Community Outreach Coordinator Volunteers Total Fairs 14 22* 36 Presentations 18 43* 61 *number officially reported to the WVPC See next page

22 National Poison Prevention Week 2015 WVPC theme: Poisoned? Not Sure? Stop Searching. Just call s theme focused on teaching West Virginians the importance of calling our medical experts at WVPC instead of searching online for poison related information. All 55 counties were reached with poison prevention information NPPW highlights include: Information featured at several WV health clinics and centers Poison prevention presentations by WV Pharmacists and Pharmacy students

23 Media Outreach West Virginia media outlets were provided with over 12 press releases throughout 2015 Press releases included: cold and flu season safety, standardized medication dosing instruments, National Poison Prevention Week, vacation safety, study drugs, holiday toy safety Media outlets included: The Inter-Mountain, WBOY, WSAZ, The Herald- Dispatch, WOWK, The Exponent Telegram Newspapers Television Radio 59* 23* 1* *number seen by WVPC See next page

24 LINK The West Virginia Poison Center s mobile-ready website is updated regularly. From this website, users can download WVPC educational materials and find information regarding a variety of poison prevention and poison center awareness topics. The WVPC website averages around 2500 visitors a month. One of the most popular pages is our Free Poison Prevention Material Downloads (seen above).

25 Online Ordering Free online ordering on the West Virginia Poison Center website was launched in March From March 2015 through the end of 2015, nearly 75 orders were placed through the new system. Orders ranged from a single sheet of Mr. Yuk stickers for home use to thousands of items being used by our community partners to educate West Virginians on poison prevention and the West Virginia Poison Center.

26 Health Professional Education Supervised experience in the WV Poison Center: Doctor of Pharmacy Students (5 wks each) 8 Occupational Medicine Resident, WVU; hours 4 Hours of academic, continuing education (CE) presentations 6 Number of toxicology lectures given (3 rd year medical students) 5 Hours of didactic/laboratory instruction WVU School of Pharmacy 29 Statewide Webinar for health care professionals 1 National meeting presentations 2 Hours of didactic instruction for other institutions 2 Hours of emergency medicine resident instruction 36 Weapons of mass destruction/disaster planning instruction (CE) 16

27 Mountain State PoisonLine Articles Volume 9, Issue 1: January-April What s New in Toxicology: Fomepizole Antidote Shortage Clinical Toxicology Pearls: Crotalid Snake Bites Poisoning Pitfalls: Use of Physical Restraints Multidisciplinary Toxicology Case: Snake Bite Volume 9, Issue 2: May-August What s New in Toxicology: Hospital Ethylene Glycol & Methanol Testing Capabilities Clinical Toxicology Pearls: The Lactate Gap Poisoning Pitfalls: Pulse Oximetry Testing Considerations Multidisciplinary Toxicology Case: Household Cleaners Volume 9, Issue 3: September-December What s New in Toxicology: Designer Fentanyl and Fentanyl Analogs Clinical Toxicology Pearls: Carbon Monoxide Management Poisoning Pitfalls: Interpretation of Fentanyl Screen Results Multidisciplinary Toxicology Case: Carbon Monoxide

28 Committee Representation-Director American Association of Poison Control Centers Chair, Quality Assurance Taskforce Co-Chair, Manager s Benchmarking Sub-Committee Member, Rapid-Response Coding Team Member, Fatality Review Committee Chair, AAPCC/Truven Coding Task Force Member, National Poison Data System Steering Committee West Virginia University Member, Occupational Medicine Residency Advisory Committee West Virginia Bureau for Public Health Deputy Strategic National Stockpile/Medical Counter Measures Coordinator Smallpox Response Team Member Emergency Medical Services for Children Advisory Panel, Member Kanawha/Putnam Local Emergency Planning Committee, Member

29 Call Type Poison Exposure Call 16,271 Information Call 11,577 Follow up Calls Made = 21,565

30 Reason for Exposure Unintentional (Accidental) 9,393 Intentional Therapeutic Error 2,105 3,102 Adverse Reaction Occupational Other Unknown ,000 10,000 Unintentional (Accidental) Exposures* = 61% of Calls

31 6% Caller Sites 24% Residence Hospitals / Physician's Office Other* 70% *Ambulances, schools, veterinarians, pharmacists, workplace, restaurants

32 Treatment Site 4% 1% 33% Health Care Facility Home Refused Referral 63% Other/Unknown

33 Route of Exposure Ingestion 13,045 Through the Skin Inhalation In Eye Bite/Sting Injection Unknown Other 1,293 1, Ingestion was the route for 79% of calls

34 1400 Age and Sex Distribution Male Female 90yrs < yrs 13 19yrs 20 29yrs 30 39yrs 40 49yrs 50 59yrs 60 69yrs 70 79yrs 80 89yrs Children 2 years of age = 36% of exposure calls

35 Drug Exposures 1 Pain Medications 1,946 2 Sedatives/Antipsychotics 1,344 3 Heart Drugs Antidepressants Antihistamines Anticonvulsants (Seizure Medications) Topicals Ethanol Stimulants/Street Drugs Diabetes medications, thyroid medications, oral contraceptives, hormones/hormone antagonists 461

36 Non-Drug Exposures 1 Household Cleaners 1,546 2 Cosmetics and Personal Care Products 1,330 3 Pesticides (Insecticides and Rodenticides) Gasoline and Automotive Toys and Miscellaneous Foreign Bodies Plants Bites and Envenomations Fumes, Gases, and Vapors Chemicals Arts and Crafts Supplies 185

37 Medical Outcome Minor Effect 2,843 No Effect 2,079 Moderate 1,422 Unrelated Effect 492 Major Death No follow up done as ingestion not toxic = 394 No follow up done as only minor symptoms anticipated = 7,258 No follow up done as patient lost to follow up or refused follow up = 813 Effects nor related to the exposure = 492 cases

38 Hospital Call Statistics 2015 HOSPITAL #CALLS TO WVPC* #PT's REFERRED TO ER+ Beckley Appalachian Regional Healthcare Berkeley Medical Center (formerly City Hospital) Bluefield Regional Medical Center Boone Memorial Hospital 43 6 Braxton County Hospital 33 4 Broaddus Hospital 19 6 Cabell Huntington Hospital Camden Clark Medical Center - Memorial Campus Charleston Area Medical Center - General Charleston Area Medical Center - Memorial Charleston Area Medical Center - Women & Children's Charleston Area Medical Center - Teays Valley 29 8 Davis Memorial Hospital Fairmont Regional Medical Center 38 9 Grafton City Hospital 28 1 Grant Memorial Hospital Greenbrier Valley Medical Center Hampshire Memorial Hospital 20 5 Jackson General Hospital 37 6 See next page

39 Hospital Call Statistics 2015 HOSPITAL #CALLS TO WVPC* #PT's REFERRED TO ER+ Jefferson Medical Center Logan Regional Medical Center Minnie Hamilton Health System 2 0 Monongalia General Hospital Montgomery General Hospital 14 4 Ohio Valley Medical Center Plateau Medical Center Pleasant Valley Hospital 23 6 Pocahontas Memorial Hospital 14 5 Potomac Valley Hospital 32 2 Preston Memorial Hospital 31 4 Princeton Community Hospital Raleigh General Hospital Reynolds Memorial Hospital 25 8 Roane General Hospital 15 3 Sistersville General Hospital 15 2 St. Francis Hospital 34 2 St. Joseph's -Buckhannon 73 6 St. Mary's Medical Center Stonewall Jackson Memorial 32 8 See next page

40 Hospital Call Statistics 2015 HOSPITAL #CALLS TO WVPC* #PT's REFERRED TO ER+ Summers County ARH Summersville Regional Medical Center Thomas Memorial Hospital United Hospital Center VA Hospital: Beckley 1 0 VA Hospital: Clarksburg (Louis A. Johnson VA Medical Center) 0 2 VA Hospital: Huntington 1 3 VA Hospital: Martinsburg 19 0 War Memorial Hospital, Inc West Virginia University Hospitals, Inc Webster County Memorial Hospital 10 5 Weirton Medical Center 3 7 Welch Community Hospital 81 9 Wetzel County Hospital 29 3 Wheeling Hospital Williamson Memorial Hospital 54 8 * Number of times Emergency Room consulted the West Virginia Poison Center +Number of patients referred by the WVPC to that Emergency Room (excludes patients refusing referral) It is the WVPC policy to refer patients needing to be seen by a physician to the closest Emergency Room

41 ANNUAL REPORT 2015 HUMAN EXPOSURE BY COUNTY TABLE OF CONTENTS COUNTY POPULATION HUMAN EXPOSURES PENETRANCE Barbour 16, Berkeley 108, Boone 24, Braxton 14, Brooke 23, Cabell 97, Calhoun 7, Clay 9, Doddridge 8, Fayette 45, Gilmer 8, Grant 11, Greenbrier 35, Hampshire 23, Hancock 30, Hardy 13, Harrison 68, Jackson 29, Jefferson 55, Kanawha 191, Lewis 16, Lincoln 21, Logan 35, Marion 56, Marshall 32, Mason 27, McDowell 20, Mercer 61, Mineral 27, Mingo 25, Monongalia 102, Monroe 13, Morgan 17, Nicholas 25, Ohio 43, Pendleton 7, Pleasants 7, Pocahontas 8, Preston 33, Putnam 56, Raleigh 78, Randolph 29, Ritchie 10, Roane 14, Summers 13, Taylor 16, Tucker 6, Tyler 8, Upshur 24, Wayne 41, Webster 8, Wetzel 16, Wirt 5, Wood 86, Wyoming 23, Not specified TOTALS 1,854,304 16, RETURN TO TABLE OF CONTENTS

42 WV County Penetrance Map 2015

43 DRUG SUBSTANCES INDEX ANALGESICS CARDIOVASCULAR MUSCLE RELAXANTS ANESTHESTICS COUGH & COLD NARCOTIC ANTAGONISTS ANTICHOLINERGICS DIAGNOSTIC AGENTS SEDATIVE/HYPNOTICS Antianxiety & Antipsychotics ANTICOAGULANTS DIETARY SUPPLEMENTS SERUMS, TOXOIDS & VACCINES ANTICONVULSANTS DIURETICS STIMULANTS & STREET DRUGS ANTIDEPRESSANTS ELECTROLYTE/MINERALS TOPICALS ANTIHISTAMINES EYE/EAR/NOSE/THROAT VETERINARY DRUGS ANTIMICROBIALS GASTROINTESTINAL VITAMINS ANTINEOPLASTICS HORMONES & ANTAGONISTS OTHER/UNKNOWN ASTHMA THERAPIES MISCELLANEOUS DRUGS Next Page

44 DRUG SUBSTANCES ANALGESICS ANESTHESTICS Acetaminophen (APAP)/Aspirin Combination 55 Inhalation, Injectable Anesthetics 1 Acetaminophen Alone 393 Local, Topical or Other Anesthetics 37 APAP in Combination 133 ANESTHETICS CATEGORY TOTAL 38 Aspirin (ASA) Alone 116 ANTICHOLINERGICS CATEGORY TOTAL 73 Acetaminophen with Hydrocodone 134 ANTICOAGULANTS Acetaminophen with Oxycodone 73 Warfarin 18 Aspirin in Combination 14 Other 65 Ibuprofen 422 ANTICOAGULANTS CATEGORY TOTAL 83 Naproxen 79 ANTICONVULSANTS Opioids Single Ingredient 407 Carbamazepine 31 Cox 2 Inhibitors 13 Phenytoin 18 Other NSAID 76 Valproic Acid 52 Other/Unknown 31 Gabapentin 320 ANALGESICS CATEGORY TOTAL 1946 Lamotrigine 86 Previous Page Next Page

45 DRUG SUBSTANCES ANTICONVULSANTS (cont d) ANTIHISTAMINES CATEGORY TOTAL 798 Topiramate 58 ANTIMICROBIALS Other 138 Antibiotics Topical 51 ANTICONVULSANTS CATEGORY TOTAL 703 Antibiotics Systemic 266 ANTIDEPRESSANTS Antifungals 59 Cyclic Antidepressants 71 Antihelmintics 39 Lithium 45 Antiparasitcs 13 SSRI 385 Antivirals 22 Trazodone 164 Other/Unknown 3 Other 215 ANTIMICROBIALS CATEGORY TOTAL 453 ANTIDEPRESSANTS CATEGORY TOTAL 880 ANTINEOPLASTICS CATEGORY TOTAL 15 ANTIHISTAMINES ASTHMA THERAPIES H 2 Receptor Antagonists 72 Albuterol 37 Diphenhydramine Alone 306 Aminophylline/Theophylline 1 Other Antihistamines Alone 420 Leukotriene Inhibitors 66 Previous Page Next Page

46 DRUG SUBSTANCES ASTHMA THERAPIES (cont d)asthma CARDIOVASCULAR CATEGORY TOTAL 970 Other Asthma Therapeutic Agents 38 COLD &COUGH PREPARATIONS ASTHMA THERAPIES CATEGORY TOTAL 142 With Opiates 4 CARDIOVASCULAR DRUGS With Dextromethorphan 262 ACE Inhibitors/Angiotension Receptor Blockers 246 Other/Unknown 138 Alpha Blockers 33 COLD & COUGH CATEGORY TOTAL 404 Antiarrhythmics 20 DIETARY SUPPLEMENTS/NEUTRACEUTICALS Antihyperlipidemics 128 Homeopathic 67 Antihypertensives/Diuretics [excluding vasodilators] 21 Melatonin 198 Beta Blockers 238 Other 115 Calcium Antagonists 108 NEUTRACEUTICALS CATEGORY TOTAL 380 Cardiac Glycosides 20 DIURETICS Clonidine 104 Furosemide 25 Nitrates 22 Thiazide 49 Other 30 Other/Unknown 19 Previous Page Next Page

47 DRUG SUBSTANCES DIURETICS CATEGORY TOTAL 93 EYE, EAR, NOSE & THROAT (ENT) PREPARATIONS (cont d) ELECTROLYTES/MINERALS Throat Preparations 0 Calcium and Calcium Salts 74 ENT PREPARATIONS CATEGORY TOTAL 150 Fluoride (excluding vitamins & mouthwash) 5 GASTROINTESTINAL PREPARATIONS Iron (excluding vitamins with iron) 32 Antacids 51 Potassium 19 Antidiarrheals 7 Sodium 37 Antispasmotics 29 Zinc 2 Laxatives 118 Other 26 Proton Pump Inhibitors 108 ELECTROLYTES/MINERALS CATEGORY TOTAL 195 Other/Unknown 85 EYE, EAR, NOSE & THROAT PREPARATIONS GASTROINTESTINAL CATEGORY TOTAL 398 Ear (Otic) Preparations 38 HORMONES/HORMONE ANTAGONISTS Eye (Ophthalmic) Preparations 68 Corticosteroids 108 Nose (Nasal) Preparations 23 Estrogens 13 Steroids Topical for Eye/Nose/Throat 11 Insulin 57 Previous Page Next Page

48 DRUG SUBSTANCES HORMONE/HORMONE ANTAGONISTS (cont d) SEDATIVES/ANTI ANXIETY/ANTI PSYCHOTICS Oral Contraceptives 36 Atypical anti psychotics 313 Oral Hypoglycemics 119 Barbiturates 23 Thyroid Preparations 104 Benzodiazepines 725 Other/Unknown 19 Buspirone 61 HORMONES CATEGORY TOTAL 461 Phenothiazines 29 MISCELLANEOUS DRUGS CATEGORY TOTAL 192 Sleep Aids, Non Prescription Only 14 MUSCLE RELAXANTS Other/Unknown 149 Carisoprodol 25 SEDATIVES/ANTI ANXIETY/ANTI PSYCHOTICS CATEGORY TOTAL Cyclobenzaprine 92 SERUMS, TOXOIDS & VACCINES CATEGORY TOTAL Methocarbamol 27 STIMULANTS & STREET DRUGS Other 87 Amphetamines & Related Compounds 108 MUSCLE RELAXANTS CATEGORY TOTAL 231 Bath Salts/Hallucinogenic Amphetamine 6 NARCOTIC ANTAGONIST CATEGORY TOTAL 8 Caffeine 21 Previous Page Next Page

49 DRUG SUBSTANCES STIMULANTS & STREET DRUGS (cont d) TOPICALS (cont d) Cocaine 21 Hydrogen Peroxide 3% 58 Heroin 63 Iodine or Iodide 6 LSD 5 Methyl Salicylate 66 Marijuana 31 Topical Steroids 62 Methamphetamines 46 Other Type of Topical 76 Methylphenidate 59 TOPICALS CATEGORY TOTAL 667 Synthetic Marijuana 84 VETERINARY DRUGS CATEGORY TOTAL 36 Other/Unknown 26 VITAMINS STIMULANT/STREET DRUGS CATEGORY TOTAL 485 Multiple Vitamins: Adult 44 TOPICALS Multiple Vitamins: Children s 194 Acne Preparation 13 Multiple Vitamins with Iron: Adult 38 Calamine 26 Multiple Vitamins with Iron: Children s 31 Camphor Alone or in Combination 119 Vitamins Single Ingredient 134 Diaper Care & Rash Products 241 Other/Unknown 7 Previous Page Next Page

50 DRUG SUBSTANCES VITAMINS CATEGORY TOTAL 448 OTHER/UNKNOWN DRUG CATEGORY TOTAL 163 Previous Page Next Page

51 NON DRUG SUBSTANCES INDEX (page 1 of 2) ADHESIVES, GLUE, CEMENTS & PASTES DEODORIZERS (not for personal use) HERBICIDES ALCOHOLS DYES HYDROCARBONS ARTS, CRAFTS, WRITING PRODUCTS & OFFICE SUPPLIES AUTOMOTIVE/AIRCRAFT/BOAT PRODUCTS BATTERIES BITES & ENVENOMATIONS BUILDING & CONSTRUCTION PRODUCTS CHEMICALS ESSENTIAL OILS FERTILIZERS FIRE EXTINGUISHERS FOOD & FOOD POISONING FOREIGN BODIES, TOYS, MISC. FUMES, GASES, VAPORS INSECTICIDES LACRIMATORS MATCHES / FIREWORKS/ EXPLOSIVES MOTHBALLS & OTHER MOTH REPELLANTS MUSHROOMS PAINTS/ ARNISHES/ LACQUERS STRIPPING AGENTS CLEANING SUBSTANCES FUNGICIDES PHOTOGRAPHIC PRODUCTS COSMETICS & PERSONAL CARE PRODUCTS HEAVY METALS PLANTS Next Page

52 NON DRUG SUBSTANCES INDEX (page 2 of 2) You may click category topic or scroll through pages that follow POLISHES & WAXES RADIATION RODENTICIDES SPORTING EQUIPMENT SWIMMING POOL & AQUARIUM PRODUCTS TOBACCO PRODUCTS UNKNOWN SUBSTANCES (NON DRUGS) WATER PROOFERS / SEALANTS Next Page

53 NON DRUG SUBSTANCES ADHESIVES, GLUE, CEMENTS & PASTES ARTS, CRAFTS, WRITING PRODUCTS & OFFICE SUPPLIES (cont d) Cyanoacrylates 36 Crayon 8 Epoxy 2 Pencil 3 Non Toxic (Paper Glue, etc.) 5 Pens / Ink 77 Other/Unknown 28 Typewriter Correction Fluid 1 ADHESIVES, GLUES, CEMENTS, PASTES 71 Water Color 9 CATEGORY TOTAL ALCOHOLS Other/Unknown 81 Methanol 8 ARTS/CRAFTS/ETC. CATEGORY TOTAL 185 Ethanol 498 AUTOMOTIVE/AIRCRAFT/BOAT PRODUCTS Isopropanol / Rubbing Alcohol 96 Ethylene Glycol (e.g., antifreeze) 67 Other/Unknown 3 Brake Fluid 18 ALCOHOLS CATEGORY TOTAL 605 Hydrocarbons 20 ARTS, CRAFTS, WRITING PRODUCTS & OFFICE SUPPLIES Methanol (e.g., dry gas, windshield wiper cleaners) Chalk 6 Other/Unknown Previous Page Next Page

54 NON DRUG SUBSTANCES AUTOMOTIVE/AIRCRAFT/BOAT PRODUCTS 140 BITES & ENVENOMATIONS (cont d) CATEGORY TOTAL BATTERIES Other Type Insect/Spider Bite 49 Penlight/Flashlight/Dry Cell 44 BITES CATEGORY TOTAL 266 Automotive Batteries 5 BUILDING /CONSTRUCTION PRODUCTS Disc Batteries 19 Caulking Compounds 33 Other/Unknown 0 Cement, Concrete 15 BATTERIES CATEGORY TOTAL 68 Insulation 10 BITES & ENVENOMATIONS Other/Unknown 31 Fish, Other Aquatic Species 8 BUILDING PRODUCTS CATEGORY TOTAL 89 Insects 99 CHEMICALS Mammals 24 Acetone (excluding nail polish remover) 5 Reptiles 3 Acids 37 Snakes 78 Alkali 22 Black Widow Spider 1 Ammonia 14 Brown Recluse Spider (reported; none in WV) 4 Borates/Boric Acid 35 Previous Page Next Page

55 NON DRUG SUBSTANCES CHEMICALS (cont d) CLEANING SUBSTANCES (cont d) Glycols 1 Laundry Detergents/Fabric Softeners 216 Other/Unknown 108 Miscellaneous Cleaning Agents 214 CHEMICALS CATEGORY TOTAL 222 Oven Cleaners 14 CLEANING SUBSTANCES Rust Removers 2 Ammonia Cleaners 1 Spot Removers/Dry Cleaning Agents 48 Automatic Dishwasher Detergents 132 Toilet Bowl Cleaners 82 Bleaches 282 Wall/Floor/Tile, Heavy Duty Cleaners 172 Carpet/Upholstery Cleaner 25 Cleaning Agents Industrial 71 Cleaners/Cleansers 25 CLEANING SUBSTANCES CATEGORY TOTAL 1546 Disinfectants 99 COSMETICS & PERSONAL CARE PRODUCTS Drain Cleaners 47 Bath Oil, Bubble Bath 17 Fabric Softeners 13 Baby Oil 11 Glass Cleaners 44 Creams, Lotions, Make Up 172 Hand Dishwashing Detergent 59 Dental Care Products 137 Previous Page Next Page

56 NON DRUG SUBSTANCES COSMETICS & PERSONAL CARE PRODUCTS (cont d) DEODORIZERS (NOT PERSONAL USE) Deodorants 138 Air Fresheners 117 Hair Care Products 107 Toilet Bowl Deodorizers 1 Hand Sanitizers 181 Other/Unknown 64 Lipsticks & Lip Balms 27 DEODORIZERS CATEGORY TOTAL 182 Mouthwash 92 DYES Nail Products 171 Food Dye 6 Perfume, Cologne, Aftershave 82 Other/Unknown 2 Peroxide 29 DYES CATEGORY TOTAL 8 Powders Made of Talc 13 ESSENTIAL OILS CATEGORY TOTAL 80 Soaps (Bar, Hand, or Complexion) 74 FERTILIZERS Suntan/Sunscreen Products 55 Household Plant Food 14 Other 24 Outdoor Fertilizers 9 COSMETICS & PERSONAL CARE PRODUCTS CATEGORY TOTAL 1330 Other/Unknown 5 Previous Page Next Page

57 NON DRUG SUBSTANCES FERTILIZERS CATEGORY TOTAL 28 FUMES, GASES, & VAPORS FIRE EXTINGUISHERS CATEGORY TOTAL 16 Carbon Monoxide 102 FOOD & FOOD POISONING 212 Chloramine Gas 31 FOREIGN BODIES, TOYS, & MISCELLANEOUS Chlorine from Acid Mixed with Bleach 40 Bubble Blowing Solution 22 Chlorine Gas 11 Christmas Ornaments 5 Hydrogen Sulfide 13 Coins 29 Methane &Natural Gas 11 Dessicants 173 Other/Unknown 32 Glass 24 FUMES, GATES, CATEGORY TOTAL 240 Glow Products 159 FUNGICIDES CATEGORY TOTAL 6 Thermometers 8 HEAVY METALS Toys 53 Elemental Mercury 4 Other/Unknown 237 Lead 18 FOREIGN BODIES, TOYS, & MISCELLANEOUS CATEGORY TOTAL 710 Other/Unknown 49 Previous Page Next Page

58 NON DRUG SUBSTANCES HEAVY METALS CATEGORY TOTAL 71 HYDROCARBONS (cont d) HERBICIDES Other/Unknown 49 Chlorphenoxy 4 HYDROCARBONS CATEGORY TOTAL 284 Glyphosate 18 INSECTICIDES Other 12 Arsenic 0 HERBICIDES CATEGORY TOTAL 27 Borates/Boric Acid 82 HYDROCARBONS Carbamates 12 Fluorocarbon/Propellants 36 Chlorinated Hydrocarbons 3 Gasoline 88 Organophosphates 16 Kerosene 20 Piperonyl Butoxide & Pyrethrins / 262 Pyrethroids Lamp Oil 17 Repellants 37 Lighter Fluid/Naptha 12 Other/Unknown 195 Lubricating Oils/Motor Oils 45 INSECTICIDES CATEGORY TOTAL 607 Mineral Spirits/Varsol/Toluene 13 LACRIMATORS CATEGORY TOTAL 45 Turpentine 4 MATCHES/FIREWORKS/EXPLOSIVES CATEGORY TOTAL 13 Previous Page Next Page

59 NON DRUG SUBSTANCES MOTHBALLS & OTHER MOTH REPELLANTS CATEGORY TOTAL 31 RODENTICIDES MUSHROOMS CATEGORY TOTAL 60 Anticoagulant WarfarinType 4 PAINTS, VARNISHES, LACQUERS, STRIPPING AGENTS CATETORY TOTAL 89 Anticoagulant Long Acting Type 131 PHOTOGRAPHIC PRODUCTS CATEGORY TOTAL 0 Other/Unknown 61 PLANTS RODENTICIDES CATEGORY TOTAL 196 Amygdalin/Cyanogenic Glycosides 19 SPORTING EQUIPMENT CATEGORY TOTAL 5 Dermatitis Producing 30 SWIMMING POOL & AQUARIUM PRODUCTS CATEGORY TOTAL 110 Gastrointestinal Irritants 50 TOBACCO PRODUCTS CATEGORY TOTAL 141 Non Toxic 34 UNKNOWN SUBSTANCES NON DRUGS CATEGORY TOTAL Oxalate Containing 31 WATER PROOFERS/SEALANTS CATEGORY TOTAL Other/Unknown 122 PLANTS CATEGORY TOTAL 286 POLISHES & WAXES CATEGORY TOTAL 27 RADIATION CATEGORY TOTAL 8 Previous Page Next Page

60 WEST VIRGINIA POISON CENTER PUBLIC HEALTH DATA The West Virginia Poison Center (WVPC) participates in the National Poisoning Data System (NPDS). The WVPC monitors its own data in addition to sending de-identified patient information to the national database every 4 to 10 minutes. * The CDC and AAPCC have developed methods to use NPDS data for real-time automated alerting that will generate more immediate and effective responses to public health threats related to toxins or chemicals in the environment. The NPDS database is a flexible and adaptable system that can be used to: identify early indicators for chemical exposures occurring at multiple sites throughout the United States; identify emerging problems that may be associated with newly in introduced household products, pharmaceuticals, or pesticides. identify illnesses resulting from intentional or unintentional chemical exposures at a single site or across multiple locations; and monitor the frequency of reports involving potentially abused substances. *From the Department of Health and Human Services Centers for Disease Control and Prevention Fact Sheet: Using the National Poisoning Data System for Public Health Surveillance

61 WEST VIRGINIA POISON CENTER PUBLIC HEALTH DATA cont d Examples of Poisoning Surveillance Activities for 2015 Identify early indicators for chemical exposures.. The WVPC worked with the WV Bureau of Public Health (WV BPH) to send information to health care professionals. The WVPC also provided epidemiological information relating to the recall to the WV BPH. Calls relating to therapeutic drug errors (when age known): <6 years of age 19.1% of drug error cases 6 to 12 years of age 13.5% of drug error cases 50 to 59 years of age 8.0% of drug error cases 60 to 69 years of age 11.7% of drug error cases 30.9% of all calls for those 6-12 years of age; reason for exposure = therapeutic drug error 47.0% of all calls for those age years of age; reason for exposure = therapeutic drug error Identify illnesses resulting from intentional or unintentional chemical exposures.. The WVPC fielded questions regarding a wide variety of public health concerns: Suspected food poisoning/adverse reactions to food Animal bites Infectious diseases 277 cases 24 cases 18 cases

62 WEST VIRGINIA POISON CENTER Use of Naloxone by Non-Health Care Providers (Law Enforcement, Fire Department, Lay Public) In 2015, the WV Legislature passed SB 335 which authorized the use of the opioid antidote, naloxone, by initial responders (meaning non-health care providers who are the first to come upon a person who has overdosed on an opioid). The legislature required that the number of times that naloxone is used by an initial responder be tracked: Data collection and reporting requirements; training. (1) The Office of Emergency Medical Services shall collect data regarding each administration of an opioid antagonist by an initial responder. The WV Office of Emergency Medical Services is utilizing the services of the WV Poison Center (WVPC) to collect this data. As the WVPC is open 24 hours a day, 7 days a week, notifications can be made at any time. The first use of naloxone by a member of law enforcement took place in November By the end of 2015, a total of two administrations by law enforcement in WV had been reported. Opioids Include: Heroin Fentanyl Morphine Oxycodone Hydrocodone Codeine Oxymorphone Others In 2015: 614 overdoses involving opioids were reported to the WV Poison Center Calls are received from both residential and hospital settings. This makes the WV Poison Center unique as collected information is not limited to the hospital setting or to fatalities only.

63 Hazardous Material (HAZMAT) Functions of the WVPC Maintaining extensive and updated references and resources on hazardous materials and chemicals. WVPC staff includes Poison Specialists with additional training in both advanced and basic HazMat Life Support and Homeland Security Exercise and Evaluation training. All staff having Incident Command System training. Availability of occupational, toxicological, and medical specialty consultants 24 hours a day. Identification of chemicals or hazardous materials based on placard symbols, CAS or UN numbers, chemical formula, or chemical name. Provision of information and assessment regarding exposure health risks and potential clinical effects. Assists with both in-field patient management and triage as well as providing health care facility treatment advice. The ability to, if appropriate, contact/alert receiving health care facilities located in the incident area as well as provide further decontamination exposure management recommendations by both telephone and facsimile. The ability, when the WVPC is advised of the incident, to provide the public with information regarding risk assessment and management. This helps to minimize the workload on emergency medical services and hospital emergency departments.

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