Certified as a Regional Poison Center by the American Association of Poison Control Centers

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1 Certified as a Regional Poison Center by the American Association of Poison Control Centers

2 WVPC Annual Report 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 DATA Professional Education Committee Representations 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 Lay Public Administration and Assistance Hazardous Materials Operations WVPC s UNIFYING THEME

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

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.

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.

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 Renewal submitted Nov 2016 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 Safety Data Sheets (SDS s) Language Line

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

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

Coordinator/Prevention Education Web Site: www.wvpoisoncenter.

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, 2016-December 31, 2016 Director: Elizabeth J. Scharman, Pharm.D., DABAT*, BCPS**, FAACT` Professor, WVU School of Pharmacy, Dept. of Clinical Pharmacy Medical Director: Michael Abesamis, M.D., ABMT^ (July 1 to present) Anthony F. Pizon, M.D., ABMT^, ABEM^^ (Jan 1 to June 30 th ) Back-up Medical Directors: Michael Lynch, M.D., ABMT^, Michael Abesamis, M.D., ABMT^ (Jan 1 to June 30) Anthony F. Pizon, M.D., ABMT^, ABEM^^ (July 1st to present) 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 # Community Outreach Coordinator: Administrative Assistant: Pamela J. Chase, RN, CSPI # Nicole D. Clendenin, BSN, RN, SPI Willette K. Haught, RN, CSPI # 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 Staff Photo Page

, DABAT, BCPS, FAACT; Director Jamie Cook, RN,

Aliff, RN, BSN, CSPI AHLS; Logistics Supervisor

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. Mike Abesamis, M.D., ABEM and Medical Toxicologist; Lead Medical Director Carissa McBurney, MPA; Community Outreach Coordinator

12 WV Poison Center Poison Specialists 2 Poison Specialists not pictured

WV Poison Center Poison Clinical and Medical Direction Dr. Elizabeth Scharman, Pharm.D., DABAT, BCPS, FAACT; Director Dr.

Joseph Yanta, MD, ABEM (far right) The Lead Medical Director, Dr.

and medical toxicology consultative services for health care professionals and WVPC Poison Specialists.

13 WV Poison Center Poison Clinical and Medical Direction Dr. Elizabeth Scharman, Pharm.D., DABAT, BCPS, FAACT; Director Dr. Mike Abesamis, MD, ABEM (left), Dr. Mike Lynch, MD, ABEM, Dr. Tony Pizon, MD, ABEM, Dr. Joseph Yanta, MD, ABEM (far right) The Lead Medical Director, Dr. Abesamis, 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 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: Office of Military Affairs and Public Safety: John C. Linton, Ph.D., ABPP, Chair 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 83.5% Office Supplies, Databases, Software, & Educational Materials 9.5% Emergency Toll Free Lines/Telecommunications 3.8% Capitol Equipment, Information Technology Support, & Maintenance 1.8% 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.

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

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 16-17): WV Legislature: $ 712, Federal Grant and Phone Support: $ 92, Member Treatment Hospitals: $ 131, Grants/donations/other: $ 47,682.00

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

Community Outreach Poison prevention awareness programs for adults, children and medical professionals Poison prevention and WVPC awareness messages are provided via: volunteer program website

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 Poison Prevention Activities Carissa McBurney, the Poison Center s Community Outreach Coordinator, goes into the community to provide education. She also trains volunteers to help ensue that all communities in WV receive poisoning prevention information.

22 Public Education Activities Poison Prevention Awareness in all 55 West Virginia counties throughout 2016 Distributed 69,280 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 12 19* 31 Presentations 21 38* 59 *number officially reported to the WVPC

staff posted on the Poison Center s Facebook page Several presentations to schools, daycare centers, after-school programs Volunteer Rob Rosiek, a Kroger

23 National Poison Prevention Week 2016 WVPC theme: Poisoned? Call our Medical Experts All 55 counties were reached with poison prevention information NPPW highlights included: Videos of interviews with WV Poison Center staff posted on the Poison Center s Facebook page Several presentations to schools, daycare centers, after-school programs Volunteer Rob Rosiek, a Kroger pharmacist from Oak Hill teaches students about poison prevention. Rob reached over 1,000 students in Fayette County during National Poison Prevention Week. A game Kim Liston, MSW with Preston Memorial Hospital plays with children to distinguish poisons from non-poisons.

24 Media Outreach West Virginia media outlets were provided with 6 press releases throughout 2016 Press release topics included: Medication Safety for Teens and Young Adults, Warm Weather Poisons, Snakes, Pesticides, Pet Poisonings During the Holidays, Naloxone Media outlets included: WBOY, Charleston Gazett , The Herald- Dispatch, WVNS, WTRF, WCHS Charleston, Clarksburg Exponent, WSAZ Huntington, WOWK Channel 13, Channel 5 Bridgeport, Channel 8 Raleigh County Newspapers Television Radio 39* 26* 1*

25 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. In October 2016, a record 5,000 unique visitors viewed the Poison Center s website.

26 A online ordering form is available from the WV Poison Center website: Materials can be previewed on the website prior to ordering. Materials are grouped in order of intended audience. Reasonable quantities are available at no charge to individual members of the public and non-profit community groups. Online Ordering

Health Professional Education Supervised experience in the WV Poison Center: Doctor of Pharmacy Students (5 wks each) 6 Hours of academic, continuing education (CE) presentations 10 Number of

27 Health Professional Education Supervised experience in the WV Poison Center: Doctor of Pharmacy Students (5 wks each) 6 Hours of academic, continuing education (CE) presentations 10 Number of toxicology lectures given (3 rd year medical students) 6 Hours of didactic/laboratory instruction WVU School of Pharmacy 50 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

Mountain State PoisonLine Articles - 2016 Volume 11, Issue 1: January-April What s New in Toxicology: New Drugs of Abuse: Designer Opioids Clinical Toxicology Pearls: Out of Hospital Naloxone

Clinical Toxicology Pearls: Acetaminophen vs.

28 Mountain State PoisonLine Articles Volume 11, Issue 1: January-April What s New in Toxicology: New Drugs of Abuse: Designer Opioids Clinical Toxicology Pearls: Out of Hospital Naloxone Poisoning Pitfalls: Urine drug screen interpretation Multidisciplinary Toxicology Case: Acetaminophen Volume 11, Issue 2: May-August What s New in Toxicology: Rodenticides Have New Ingredients Clinical Toxicology Pearls: Acetaminophen vs. Aspirin Poisoning Pitfalls: Definition of Naloxone Response Multidisciplinary Toxicology Case: Cyanide and Smoke Inhalation Volume 11, Issue 3: September-December What s New in Toxicology: Gabapentin A Drug of Abuse? Clinical Toxicology Pearls: AST Elevations and the Poisoned Patient Poisoning Pitfalls: Non-steroidal Anti-inflammatory Drugs Multidisciplinary Toxicology Case: Ethylene glycol

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

29 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 State Epidemiological Outcomes Workgroup Emergency Medical Services for Children Advisory Panel, Member Kanawha/Putnam Local Emergency Planning Committee, Member

30 Call Type Poison Exposure Call 16,310 Information Call 7,885 Follow-up Calls Made = 19,617

31 Reason for Exposure Unintentional (Accidental) 9,187 Intentional 3,338 Therapeutic Error 2,054 Adverse Reaction Occupational Other Unknown ,000 10,000 Unintentional (Accidental) Exposures* = 59% of Calls

32 Caller Sites 9% 24% Residence Hospitals / Physician's Office Other* 67% *Ambulances, schools, veterinarians, pharmacists, workplace, restaurants

33 Treatment Site 4% 1% 33% Health Care Facility Home Refused Referral 62% Other/Unknown

34 Route of Exposure Ingestion 12,781 Through the Skin Inhalation In Eye Bite/Sting Injection Unknown Other 1,201 1, Ingestion was the route for 77% of calls

< 1 1 2 3 4 5 6-12yrs 13-19yrs 20-29yrs 30-39yrs 40-49yrs 50-59yrs 60-69yrs 70-79yrs 80-89yrs 90yrs 1400 Age and Sex

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

36 Drug Exposures 1 Pain Medications 1,902 2 Sedatives/Antipsychotics 1,203 3 Heart Drugs Antidepressants Antihistamines Stimulant/Street Drugs Anticonvulsants (Seizure Medications) Diabetes medications, thyroid medications, oral contraceptives, hormones/hormone antagonists Topicals Ethanol 546

37 Non-Drug Exposures 1 Household Cleaners 1,429 2 Cosmetics and Personal Care Products 1,274 3 Toys and Miscellaneous Foreign Bodies Pesticides (Insecticides and Rodenticides) Gasoline and Automotive Plants Bites and Envenomations Fumes, Gases, and Vapors Arts and Crafts Supplies Chemicals 189

38 Medical Outcome Minor Effect 3,243 No Effect 2,565 Moderate 1,473 Unrelated Effect Major Death No follow-up done as ingestion not-toxic = 678 No follow-up done as only minor symptoms anticipated = 5,883 No follow-up done as patient lost to follow-up or refused follow-up = 876 Effects not related to the exposure = 456 cases

39 Hospital Call Statistics 2016 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 36 5 Braxton County Hospital 22 4 Broaddus Hospital 26 3 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 Davis Memorial Hospital Fairmont Regional Medical Center Grafton City Hospital 18 5 Grant Memorial Hospital 47 8 Greenbrier Valley Medical Center Hampshire Memorial Hospital 19 4 Jackson General Hospital 29 11

40 Hospital Call Statistics 2016 HOSPITAL #CALLS TO WVPC* #PT's REFERRED TO ER+ Jefferson Medical Center Logan Regional Medical Center Minnie Hamilton Health System 9 4 Monongalia General Hospital Montgomery General Hospital 15 5 Ohio Valley Medical Center Plateau Medical Center 52 9 Pleasant Valley Hospital 31 8 Pocahontas Memorial Hospital 13 2 Potomac Valley Hospital 23 1 Preston Memorial Hospital 24 9 Princeton Community Hospital Raleigh General Hospital Reynolds Memorial Hospital 32 5 Roane General Hospital 20 6 Sistersville General Hospital 17 2 St. Francis Hospital 11 2 St. Joseph's -Buckhannon St. Mary's Medical Center Stonewall Jackson Memorial 33 5

41 Hospital Call Statistics 2016 HOSPITAL #CALLS TO WVPC* #PT's REFERRED TO ER+ Summers County ARH 15 5 Summersville Regional Medical Center Thomas Memorial Hospital United Hospital Center VA Hospital: Beckley 3 3 VA Hospital: Clarksburg (Louis A. Johnson VA Medical Center) 1 1 VA Hospital: Huntington 3 2 VA Hospital: Martinsburg 11 2 War Memorial Hospital, Inc West Virginia University Hospitals, Inc Webster County Memorial Hospital 17 4 Weirton Medical Center 3 9 Welch Community Hospital 78 5 Wetzel County Hospital 36 1 Wheeling Hospital Williamson Memorial Hospital 54 2 * Number of times Emergency Department consulted the West Virginia Poison Center +Number of patients referred by the WVPC to that Emergency Department (excludes patients refusing referral) It is the WVPC policy to refer patients needing to be seen by a physician to the closest Emergency Department

42 ANNUAL REPORT 2016 HUMAN EXPOSURE BY COUNTY 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 14, Out of State Calls* 808 *Out of state calls occur when cell phones with a WV area code exchange are used outside of WV.

43 WV County Penetrance Map 2016

44 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

45 DRUG SUBSTANCES ANALGESICS ANESTHESTICS Acetaminophen (APAP)/Aspirin Combination 43 Inhalation, Injectable Anesthetics 5 Acetaminophen Alone 413 Local, Topical or Other Anesthetics 40 APAP in Combination 88 ANESTHETICS CATEGORY TOTAL 45 Aspirin (ASA) Alone 128 ANTICHOLINERGICS CATEGORY TOTAL 90 Acetaminophen with Hydrocodone 116 ANTICOAGULANTS Acetaminophen with Oxycodone 54 Warfarin 27 Acetaminophen with Codeine 15 Other 76 Ibuprofen 439 ANTICOAGULANTS CATEGORY TOTAL 103 Naproxen 90 ANTICONVULSANTS Opioids- Single Ingredient 415 Carbamazepine 26 Cox 2 Inhibitors 5 Phenytoin 22 Other NSAID 60 Valproic Acid 59 Other/Unknown 36 Gabapentin 272 ANALGESICS CATEGORY TOTAL 1902 Lamotrigine 88

46 DRUG SUBSTANCES ANTICONVULSANTS (cont d) ANTIHISTAMINES CATEGORY TOTAL 818 Topiramate 51 ANTIMICROBIALS Other 141 Antibiotics-Topical 38 ANTICONVULSANTS CATEGORY TOTAL 659 Antibiotics-Systemic 230 ANTIDEPRESSANTS Antifungals 73 Cyclic Antidepressants 135 Antihelmintics 30 Lithium 35 Antiparasitcs 7 SSRI 399 Antivirals 19 Trazodone 142 Other/Unknown 3 Other 200 ANTIMICROBIALS CATEGORY TOTAL 400 ANTIDEPRESSANTS CATEGORY TOTAL 911 ANTINEOPLASTICS CATEGORY TOTAL 15 ANTIHISTAMINES ASTHMA THERAPIES H 2 Receptor Antagonists 80 Albuterol 45 Diphenhydramine-Alone 294 Aminophylline/Theophylline 3 Other Antihistamines-Alone 444 Leukotriene Inhibitors 52

47 DRUG SUBSTANCES ASTHMA THERAPIES (cont d)asthma CARDIOVASCULAR CATEGORY TOTAL 947 Other Asthma Therapeutic Agents 50 COLD & COUGH PREPARATIONS ASTHMA THERAPIES CATEGORY TOTAL 150 With Opiates 5 CARDIOVASCULAR DRUGS With Dextromethorphan 260 ACE Inhibitors/Angiotension Receptor Blockers 229 Other/Unknown 125 Alpha Blockers 47 COLD & COUGH CATEGORY TOTAL 390 Antiarrhythmics 14 DIETARY SUPPLEMENTS/NEUTRACEUTICALS Antihyperlipidemics 104 Homeopathic 79 Antihypertensives/Diuretics [excluding vasodilators] 25 Melatonin 206 Beta Blockers 253 Other 75 Calcium Antagonists 94 NEUTRACEUTICALS CATEGORY TOTAL 360 Cardiac Glycosides 15 DIURETICS Clonidine 109 Furosemide 39 Nitrates 24 Thiazide 40 Other 33 Other/Unknown 17

48 DRUG SUBSTANCES DIURETICS CATEGORY TOTAL 96 EYE, EAR, NOSE & THROAT (ENT) PREPARATIONS (cont d) ELECTROLYTES/MINERALS Throat Preparations 14 Calcium and Calcium Salts 88 ENT PREPARATIONS CATEGORY TOTAL 97 Fluoride (excluding vitamins & mouthwash) 3 GASTROINTESTINAL PREPARATIONS Iron (excluding vitamins with iron) 27 Antacids 50 Potassium 15 Antidiarrheals 5 Sodium 29 Antispasmotics 24 Zinc 6 Laxatives 119 Other 19 Proton Pump Inhibitors 106 ELECTROLYTES/MINERALS CATEGORY TOTAL 187 Other/Unknown 78 EYE, EAR, NOSE & THROAT PREPARATIONS GASTROINTESTINAL CATEGORY TOTAL 382 Ear (Otic) Preparations 16 HORMONES/HORMONE ANTAGONISTS Eye (Ophthalmic) Preparations 45 Corticosteroids 109 Nose (Nasal) Preparations 9 Estrogens 6 Steroids Topical for Eye/Nose/Throat 13 Insulin 75

49 DRUG SUBSTANCES HORMONE/HORMONE ANTAGONISTS (cont d) SEDATIVES/ANTI-ANXIETY/ANTI- PSYCHOTICS Oral Contraceptives 49 Atypical anti-psychotics 298 Oral Hypoglycemics 146 Barbiturates 12 Thyroid Preparations 133 Benzodiazepines 664 Other/Unknown 39 Buspirone 49 HORMONES CATEGORY TOTAL 557 Phenothiazines 25 MISCELLANEOUS DRUGS CATEGORY TOTAL 165 Sleep Aids, Non-Prescription Only 13 MUSCLE RELAXANTS Other/Unknown 142 Carisoprodol 10 SEDATIVES/ANTI-ANXIETY/ANTI- PSYCHOTICS CATEGORY TOTAL Cyclobenzaprine 96 SERUMS, TOXOIDS & VACCINES CATEGORY TOTAL Methocarbamol 22 STIMULANTS & STREET DRUGS Other 95 Amphetamines & Related Compounds 108 MUSCLE RELAXANTS CATEGORY TOTAL 223 Bath Salts/Hallucinogenic Amphetamine 10 NARCOTIC ANTAGONIST CATEGORY TOTAL 18 Caffeine 51

50 DRUG SUBSTANCES STIMULANTS & STREET DRUGS (cont d) TOPICALS (cont d) Cocaine 25 Hydrogen Peroxide 3% 43 Heroin (via calls and non-telephonic reports) 327 Iodine or Iodide 4 LSD 5 Methyl Salicylate 50 Marijuana 41 Topical Steroids 46 Methamphetamines 49 Other Type of Topical 80 Methylphenidate 51 TOPICALS CATEGORY TOTAL 556 Synthetic Marijuana 41 VETERINARY DRUGS CATEGORY TOTAL 39 Other/Unknown 18 VITAMINS STIMULANT/STREET DRUGS CATEGORY TOTAL 726 Multiple Vitamins: Adult 46 TOPICALS Multiple Vitamins: Children s 153 Acne Preparation 24 Multiple Vitamins with Iron: Adult 33 Calamine 32 Multiple Vitamins with Iron: Children s 23 Camphor Alone or in Combination 85 Vitamins Single Ingredient 115 Diaper Care & Rash Products 192 Other/Unknown 2

51 DRUG SUBSTANCES VITAMINS CATEGORY TOTAL 372 OTHER/UNKNOWN DRUG CATEGORY TOTAL 169

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

52 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

53 NON-DRUG SUBSTANCES INDEX (page 2 of 2) POLISHES & WAXES RADIATION RODENTICIDES SPORTING EQUIPMENT SWIMMING POOL & AQUARIUM PRODUCTS TOBACCO PRODUCTS UNKNOWN SUBSTANCES (NON-DRUGS) WATER PROOFERS / SEALANTS

54 NON-DRUG SUBSTANCES ADHESIVES, GLUE, CEMENTS & PASTES ARTS, CRAFTS, WRITING PRODUCTS & OFFICE SUPPLIES (cont d) Cyanoacrylates 36 Crayon 6 Epoxy 4 Pencil 8 Non-Toxic (Paper Glue, etc.) 7 Pens / Ink 80 Other/Unknown 25 Typewriter Correction Fluid 2 ADHESIVES, GLUES, CEMENTS, PASTES CATEGORY TOTAL 72 Water Color 14 ALCOHOLS Other/Unknown 86 Methanol 5 ARTS/CRAFTS/ETC. CATEGORY TOTAL 212 Ethanol 546 AUTOMOTIVE/AIRCRAFT/BOAT PRODUCTS Isopropanol / Rubbing Alcohol 80 Ethylene Glycol (e.g., antifreeze) 64 Other/Unknown 5 Brake Fluid 9 ALCOHOLS CATEGORY TOTAL 636 Hydrocarbons 20 ARTS, CRAFTS, WRITING PRODUCTS & OFFICE SUPPLIES Methanol (e.g., dry gas, windshield wiper cleaners) Chalk 16 Other/Unknown 18 12

55 AUTOMOTIVE/AIRCRAFT/BOAT PRODUCTS CATEGORY TOTAL NON-DRUG SUBSTANCES 123 BITES & ENVENOMATIONS (cont d) BATTERIES Other Type Insect/Spider Bite 46 Penlight/Flashlight/Dry Cell 45 BITES CATEGORY TOTAL 259 Automotive Batteries 4 BUILDING /CONSTRUCTION PRODUCTS Disc Batteries 20 Caulking Compounds 16 Other/Unknown 2 Cement, Concrete 8 BATTERIES CATEGORY TOTAL 71 Insulation 11 BITES & ENVENOMATIONS Other/Unknown 22 Fish, Other Aquatic Species 2 BUILDING PRODUCTS CATEGORY TOTAL 157 Insects 89 CHEMICALS Mammals 22 Acetone (excluding nail polish remover) 2 Reptiles 2 Acids 45 Snakes 95 Alkali 33 Black Widow Spider 2 Ammonia 10 Brown Recluse Spider (reported; none in WV) 1 Borates/Boric Acid 18

56 NON-DRUG SUBSTANCES CHEMICALS (cont d) CLEANING SUBSTANCES (cont d) Glycols 4 Laundry Detergents/Fabric Softeners *111 exposures to laundry pods Other/Unknown 77 Miscellaneous Cleaning Agents 177 CHEMICALS CATEGORY TOTAL 189 Oven Cleaners * CLEANING SUBSTANCES Rust Removers 5 Ammonia Cleaners 3 Spot Removers/Dry Cleaning Agents 8 Automatic Dishwasher Detergents 131 Toilet Bowl Cleaners 81 Bleaches 276 Wall/Floor/Tile, Heavy Duty Cleaners 158 Carpet/Upholstery Cleaner 19 Cleaning Agents Industrial 65 Cleaners/Cleansers 30 CLEANING SUBSTANCES CATEGORY TOTAL 1429 Disinfectants 88 COSMETICS & PERSONAL CARE PRODUCTS Drain Cleaners 38 Bath Oil, Bubble Bath 32 Fabric Softeners 15 Baby Oil 9 Glass Cleaners 38 Creams, Lotions, Make-Up 127 Hand Dishwashing Detergent 53 Dental Care Products 137

57 COSMETICS & PERSONAL CARE PRODUCTS (cont d) NON-DRUG SUBSTANCES DEODORIZERS (NOT PERSONAL USE) Deodorants 150 Air Fresheners 124 Hair Care Products 103 Toilet Bowl Deodorizers 4 Hand Sanitizers 174 Other/Unknown 55 Lipsticks & Lip Balms 28 DEODORIZERS CATEGORY TOTAL 183 Mouthwash 91 DYES Nail Products 146 Food Dye 6 Perfume, Cologne, Aftershave 69 Other/Unknown 6 Peroxide 49 DYES CATEGORY TOTAL 12 Powders Made of Talc 11 ESSENTIAL OILS CATEGORY TOTAL 110 Soaps (Bar, Hand, or Complexion) 75 FERTILIZERS Suntan/Sunscreen Products 57 Household Plant Food 11 Other 16 Outdoor Fertilizers 10 COSMETICS & PERSONAL CARE PRODUCTS CATEGORY TOTAL 1274 Other/Unknown 4

58 NON-DRUG SUBSTANCES FERTILIZERS CATEGORY TOTAL 25 FUMES, GASES, & VAPORS FIRE EXTINGUISHERS CATEGORY TOTAL 117 Carbon Monoxide 83 FOOD & FOOD POISONING 175 Chloramine Gas 26 FOREIGN BODIES, TOYS, & MISCELLANEOUS Chlorine from Acid Mixed with Bleach 39 Bubble Blowing Solution 27 Chlorine Gas 22 Christmas Ornaments 1 Hydrogen Sulfide 31 Coins 26 Methane & Natural Gas 19 Dessicants 140 Other/Unknown 38 Glass 21 FUMES, GATES, CATEGORY TOTAL 258 Glow Products 157 FUNGICIDES CATEGORY TOTAL 5 Thermometers 6 HEAVY METALS Toys 74 Elemental Mercury 3 Other/Unknown 200 Lead 13 FOREIGN BODIES, TOYS, & MISCELLANEOUS CATEGORY TOTAL 652 Other/Unknown 47

59 HEAVY METALS CATEGORY TOTAL NON-DRUG SUBSTANCES HYDROCARBONS (cont d) HERBICIDES Other/Unknown 32 Chlorphenoxy 21 HYDROCARBONS CATEGORY TOTAL 249 Glyphosate 14 INSECTICIDES Other 11 Arsenic 0 HERBICIDES CATEGORY TOTAL 96 Borates/Boric Acid 78 HYDROCARBONS Carbamates 6 Fluorocarbon/Propellants 28 Chlorinated Hydrocarbons 4 Gasoline 100 Organophosphates 5 Kerosene 9 Piperonyl Butoxide & Pyrethrins / Pyrethroids Lamp Oil 13 Repellants 45 Lighter Fluid/Naptha 16 Other/Unknown 109 Lubricating Oils/Motor Oils 42 INSECTICIDES CATEGORY TOTAL 444 Mineral Spirits/Varsol/Toluene 8 LACRIMATORS CATEGORY TOTAL Turpentine 1 MATCHES/FIREWORKS/EXPLOSIVES CATEGORY TOTAL 11

60 MOTHBALLS & OTHER MOTH REPELLANTS CATEGORY TOTAL NON-DRUG SUBSTANCES 26 RODENTICIDES MUSHROOMS CATEGORY TOTAL 40 Anticoagulant Warfarin Type 2 PAINTS, VARNISHES, LACQUERS, STRIPPING AGENTS CATETORY TOTAL 102 Anticoagulant Long Acting Type 53 PHOTOGRAPHIC PRODUCTS CATEGORY TOTAL 1 Other/Unknown 18 PLANTS RODENTICIDES CATEGORY TOTAL 73 Amygdalin/Cyanogenic Glycosides 19 SPORTING EQUIPMENT CATEGORY TOTAL 3 Dermatitis Producing 22 SWIMMING POOL & AQUARIUM PRODUCTS CATEGORY TOTAL 99 Gastrointestinal Irritants 55 TOBACCO PRODUCTS CATEGORY TOTAL 119 Non-Toxic 30 UNKNOWN SUBSTANCES NON-DRUGS CATEGORY TOTAL Oxalate Containing 24 WATER PROOFERS/SEALANTS CATEGORY TOTAL Other/Unknown 115 PLANTS CATEGORY TOTAL 265 POLISHES & WAXES CATEGORY TOTAL 43 RADIATION CATEGORY TOTAL 2

61 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

62 WEST VIRGINIA POISON CENTER PUBLIC HEALTH DATA (cont.d) Examples of Poisoning Surveillance Activities for 2016 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 20.0% of drug error cases 6 to 12 years of age 13.1% of drug error cases 50 to 59 years of age 9.2% of drug error cases 60 to 69 years of age 12.5% of drug error cases error 25.8% of all calls for those 6-12 years of age; reason for exposure = therapeutic drug error 48.8% of all calls for those age years of age; reason for exposure = therapeutic drug 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 239 cases 22 cases 13 cases

63 WEST VIRGINIA POISON CENTER Use of Naloxone by Non-Health Care Providers (Law Enforcement, Fire Department, Lay Public) Male Female 2016 was the first full calendar year in which naloxone was made available for use by police, fire departments, and the lay public. A total of 309 administrations were reported to the WV Poison Center (66 by police, 67 by fire department). The WV Poison Center partners with the WV Office of Emergency Medical Services (WV OEMS) to track naloxone administrations by police and fire department personnel. Counties Reporting: Cabell Fayette Harrison Jefferson Kanawha Mercer Monongalia Putnam

Hazardous Material (HAZMAT) Functions of the WVPC Maintaining extensive and updated references and resources on hazardous materials and chemicals.

All staff having Incident Command System training. Availability of occupational, toxicological, and medical specialty consultants 24 hours a day.

64 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.

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

Certified as a Regional Poison Center by the American Association of Poison Control Centers Go to Table of Contents WVPC Annual Report 2015 Table of Contents ABOUT US Our Mission Statement History Who