Guidelines will standardize treatment across U.S. and Canada and improve patient outcomes

New consensus guidelines for the management of acetaminophen poisoning published in JAMA Network Open  are now available to be used by Poison Centers and hospitals in the U.S. and Canada. Acetaminophen overdose continues to be a leading cause of accidental and intentional poisoning, with more than 80,000 cases reported in 2021 to U.S. Poison Centers. When not treated properly, acetaminophen poisoning causes liver failure and death.

For the first time-ever a panel of more than twenty experts were convened from America’s Poison Centers, American Academy of Clinical Toxicology (AACT), American College of Medical Toxicology (ACMT), and the Canadian Association of Poison Centres & Clinical Toxicologists (CAPCCT) to develop consensus guidelines for the treatment of acetaminophen poisoning. The guidelines were developed through a systematic review of the medical literature, including existing guidelines and 278 publications.

“These guidelines address a critical gap in the care and treatment of patients with acetaminophen poisoning, and are a significant achievement for the medical and public health community,” said Richard Dart, MD, PhD, Director of the Rocky Mountain Poison Center and chairperson of the acetaminophen panel. “Standardized guidelines will ensure that patients receive life-saving treatment sooner, resulting in better patient care and outcomes, and has the potential to save costs by reducing the length of hospital stays.”

The guidelines addressed the following topics:  

•  Assessing risk of liver injury
•   Recommended dosage and administration of activated charcoal and N-Acetylcysteine (NAC), which are used to treat acetaminophen overdose
•  Special populations (i.e. pregnant persons, children)
•   Assessing and treating high-risk ingestions (formerly called "massive overdose”)

“I want to extend a huge congratulations to all the members of the panel who participated in the development of these guidelines,” said Carol DesLauriers, PharmD, Board President, America’s Poison Centers and Assistant Vice President of the Illinois Poison Center and Illinois Health and Hospital Association. “This milestone is a testament to the hard work and collaboration among the different organizations. More importantly, it will help us drive our collective public health mission forward, and reduce the number of poison-related health emergencies.”

To read a full copy of the new guidelines, visit JAMA Network Open.

For questions related to acetaminophen or emergency assistance, contact:

•  Poison Help at 1-800-222-1222 to speak with a poison expert, or
• Visit PoisonHelp.org (the official website for America’s Poison Centers) for resources and support.

The White House Office of National Drug Control Policy recently designated xylazine combined with fentanyl as an emerging threat to the United States.  This combination is sometimes referred to by the slang term,“Tranq.” Xylazine is a non-opioid tranquilizer approved by the Food and Drug Administration (FDA) for veterinary use only. There has been a steady increase in the combination of fentanyl and xylazine being sold illegally in the United States, may lead to more severe complications from overdose.  

The introduction of xylazine has played a significant role in the opioid crisis and the increase in cases and overdose deaths seen across the country. Similar to other agencies, U.S. Poison Centers are documenting an increasing number of cases involving xylazine. In 2022, U.S. Poison Centers documented the largest annual number of cases involving xylazine noting a 173% increase in cases compared to 2019.This trend of increased xylazine exposures continues in 2023. During the first 3 months of 2023, Poison Centers have documented four times the number of xylazine cases compared to the same period in 2022.

Poison Centers offer the following precautions to protect against poisoning.

• Naloxone is safe to administer to people experiencing an overdose from xylazine combined with fentanyl. While it will not reverse the effects of xylazine, it may help by reversing the effects of fentanyl or other opioids involved.
• Call Poison Help (1-800-222-1222) to reach your local poison center if you suspect someone has been exposed to xylazine combined with fentanyl.
• Call 911 immediately if an individual is unconscious, unable to breathe, or seizing.

For additional online support and poisoning prevention resources, visit PoisonHelp.org.

Bipartisan Brown, Scott Sponsor Resolution Designating March 19-25, 2023 as National Poison Prevention Week

Every year, specially trained pharmacists, nurses, and physicians manage more than 2 million poisoning cases. While we have made great strides in the decades since National Poison Prevention Week (NPPW) was first observed more than 60 years ago poisoning remains a risk, especially for children and older adults.

The White House issued its annual proclamation for NPPW, which is recognized during the third week of March. This year’s full proclamation is available for view here. NPPW brings together the Nation’s 55 Poison Centers, community organizations, and government agencies to raise awareness of the risks of posed by poisonous substances, precautions people can take to keep their families safe, and using the Poison Help line (1-800-222-1222) and website (PoisonHelp.org) when responding to an emergency.

In addition, U.S. Senators Sherrod Brown (D-OH) and Tim Scott (R-SC) sponsored a resolution to recognize the week of March 19 through March 25, 2023, as National Poison Prevention Week. “Ohio is the proud home to two Poison Control Centers and I’m grateful for the lifesaving work the workers there do to keep our communities safe,” said Senator Brown. “As we recognize National Poison Prevention Week, we must continue to support the work of the CDC and ensure staff, faculty, and other experts at our Poison Control Centers have the resources they need to protect Ohioans.”

According to America’s Poison Centers 2021 annual report, the top five exposure substances are all products commonly found in the home. These include analgesics, household cleaners, cosmetics/personal care products, antidepressants, and sedatives.  “More than 90 percent of poisonings happen at home,” said Kaitlyn Brown, PharmD, Clinical Managing Director, America’s Poison Centers. “We know it can take only a minute for an accident to happen, especially with young children. This National Poison Prevention Week we encourage everyone to be prepared in the event of an emergency by saving 1-800-222-1222 in their contacts. This week is also a great opportunity to learn about resources and establish home safety practices.”

“Poison Centers are often the unsung heroes on the front lines of responding to poisoning and public health emergencies,” said Richard Fogelson, America’s Poison Centers, CEO. “National Poison Prevention Week serves as a reminder of the critical role that Poison Centers play in providing education and prevention information to help keep our communities and families safe.”

During a ceremony earlier today, America’s Poison Centers also awarded the winners of the 2023 NPPW Video and Poster Contest. Students in grades 5-12 from across the country are invited to submit a video or poster that showcases poison prevention safety messaging by kids and for kids. This year’s winners include:

• People’s Choice Winner:  Matthew Harvey, Grade 8, Mandarin Middle School
• Grade 5-8 Winners: Julia Aldrich & Addie Larson, Grade 8, Mandarin Middle School
• Grade 9-12 1^st Place Winner: Collin Fowler, Grade 11, Indian Trail High School
• Grand Prize Winners: DaMarcus Ganaway, Julian Shahly, William Jones & Isaiah Vieira, Grade 8, Mandarin Middle School

For additional information and to download NPPW resources please visit, America's Poison Centers - NPPW 2023.

About America’s Poison Centers

America’s Poison Centers represent 55 Poison Centers across the country. We are united in our cause to prevent every poison- and toxin-related health emergency in America. Through our national Poison Help line (1-800-222-1222) website PoisonHelp.org, we provide all Americans expert advice from nationally accredited medical specialists about potential drug interactions, poison ingestions and exposure to toxins such as insects or chemicals — available 24/7/365, at no cost. Together, America’s Poison Centers ensure a national quality standard for the detection, prevention and treatment of toxin-related health emergencies.

CONTACT:

Maggie Maloney

America’s Poison Centers

703.894.1867

[email protected]

 

Poison Centers in every state, territory and jurisdiction detect, prevent and treat a broad range of poison and toxin-related emergencies, and provide every American access to 24/7, 365 expert help

As part of its growing public health work across the country, the American Association of Poison Control Centers is modernizing its brand and has changed its name to America’s Poison Centers to reflect the full range of the Association’s services. This includes the life-saving, local emergency services that its 55 poison center members provide to every American, via a free, confidential Poison Help line 1-800-222-1222 and its website PoisonHelp.org. The organization also operates the nation’s only near-real time data system that integrates the poisoning public health data from across the nation’s 55 centers.

Much like a cardiologist specializes in heart health, Poison Centers specialize in poisonings, overdoses and toxins. The experts staffing the Poison Help line are healthcare professionals such as nurses, pharmacists and physicians.

Most Americans may know Poison Centers help with pediatric-related poison emergencies – for example, a parent calling the help line when their child ingests a harmful substance. However, there are a wide variety of situations where a poison help line expert can provide advice about a wide range of issues for people of all ages: medication interactions, food poisoning, insect exposures, snake bites, workplace or home chemical hazards, drug overdoses and any toxin-related exposure.

“Many people aren’t aware of the variety of substances that can cause serious illness or even death,” said Carol DesLauriers, a registered pharmacist who serves as both the board president for America’s Poison Centers and the director of the Illinois Poison Center. “We know accidents and the unexpected happen every day. Please save 800-222-1222 in your contacts so you have the number handy in the event of an emergency. A call can be the difference between life and death, and our trained experts are here to provide emergency medical advice and education to healthcare providers and the public, 24/7.”

Visitors to PoisonHelp.org will now find expanded first aid and education resources, and the latest data and trending topics in poison exposures. Additionally, the Get Help tool provides real-time advice and actionable next steps if you have been exposed to a potentially toxic product, poison or medication.

 Poison Centers Aid National Health Emergency Response

In addition to providing emergency resources and support, Poison Centers are on the front lines responding to many of the country’s national public health issues, including:

• Covid-19: Poison Centers managed more than 1.2 million inquiries directly related to Covid-19 in 2020-2021. Poison center data was used by public health partners to issue public health warning on alternative Covid-19 treatments.
• The Opioid crisis: Between 2019 and 2021 Poison Centers reported a 39 percent increase in severe outcomes and deaths reported from illicit and pharmaceutical opioid overdose cases.
• Cannabis: As cannabis products become more accessible and legally available in many states, Poison Centers reported a 45 percent increase in cases involving children under six between 2020 and 2021, resulting in increased healthcare facility utilization and risk for severe illness.
• E-cigarettes: With the proliferation of e-cigarette use, exposures to concentrated nicotine liquids has risen, resulting in increased risk of severe poisoning, especially in children and teens.

All cases that come into a local poison center are synced into America’s Poison Centers’ poisoning surveillance system. The National Poison Data System™ (NPDS) detects trends in toxin-related exposures and information requests, providing actionable, quality, real-time data to emergency medical teams, public health officials and others.

“As we continue to enhance our capabilities and impact for the nation, the mission of our Centers remains the same: to prevent poison and toxin-related injuries in America with 24x7 service to the public and near- real time surveillance data,” said Richard Fogelson, CEO of America’s Poison Centers. “We monitor and respond to emerging public health issues, ensure Poison Centers across the country are accredited to meet the highest standards in toxicology education, and maintain the latest and most accurate data for use by government agencies, research institutions, healthcare providers and industry.”

About America’s Poison Centers

America’s Poison Centers represents 55 poison centers across the country. We are united in our cause to prevent every poison- and toxin-related health emergency in America. Through our national Poison Help line (800-222-1222) and website PoisonHelp.org, we provide all Americans expert advice from nationally accredited medical specialists about potential drug interactions, poison ingestions and exposure to toxins such as insects or chemicals — available 24/7/365, at no cost. Together, America’s Poison Centers ensure a national quality standard for the detection, prevention and treatment of toxin-related health emergencies.

CONTACT: 

Maggie Maloney

America’s Poison Centers

703.894.1867

[email protected]

The American Association of Poison Control Centers (AAPCC) announced its officers and new members-at-large of the Board of Directors for 2022-2023. These members bring decades of experience in the field of poison information and demonstrate the vast medical expertise poison centers offer to our communities.

Carol DesLauriers, PharmD, DABAT, Assistant Vice President at the Illinois Health and Hospital Association and leader of the Illinois Poison Center will serve as the AAPCC Board President. In addition, Julie Weber, RPh, CSPI, Managing Director of the Missouri Poison Center will continue to serve on the board as Past-President. 

AAPCC also elected Alvin Bronstein, MD, FACEP, to serve as President-Elect. Dr. Bronstein is Attending Faculty at Rocky Mountain Poison and Drug Safety (RMPDS), and Branch Chief of Hawaii Department of Health.

Linda Kalin, RN, BS, CSPI, will serve a second term as Treasurer and is the Executive Director of the Iowa Poison Control Center. Shireen Banerji, PharmD, DABAT, is the newly elected Secretary and the Director of Rocky Mountain Poison and Drug Safety (RMPDS).

In addition, four new at-large members were elected to serve on the board:

• Bruce Ruck, PharmD, DABAT, Managing Director, NJ Poison Information and Education System
• Christopher Holstege, MD, Director, Blue Ridge Poison Center 
• Victoria Frankl, RN, CSPI, MPH, Education Coordinator, Northern New England Poison Center
• Wendy Stephan, PhD, MPH, CHES, Health Education Coordinator, Florida Poison Information Center-Miami

About the American Association of Poison Control Centers

The American Association of Poison Control Centers represents 55 poison centers across the country. We are united in our cause to prevent every poison- and toxin-related health emergency in America. Through our national Poison Help line (800-222-1222) and website PoisonHelp.org, we provide all Americans expert advice from nationally accredited medical specialists about potential drug interactions, poison ingestions and exposure to toxins such as insects or chemicals — available 24/7/365, at no cost. The American Association of Poison Control Centers ensure a national quality standard for the detection, prevention and treatment of toxin-related health emergencies.

For More Information, Contact:

Maggie Maloney
Director, Public Education & Communications
[email protected]

 

Poison control centers across the U.S. reported a 253 percent increase in self-poisoning with nitrites and nitrates and a 166 percent increase in fatalities in 2021 in comparison to 2018. This is at the same time there is increased accessibility of sodium nitrite through online vendors and recommendations frequently shared in online communities that it can be used as an effective method of suicide.

Sodium nitrite is a form of salt and commonly used as a food preservative. Consuming large quantities of sodium nitrite can cause methemoglobinemia, which is a dangerous and potentially fatal condition where the amount of oxygen carried by the blood is greatly reduced. The high mortality rate and toxicity of sodium nitrite is also of significant concern. Since 2018, nearly 15 percent of nitrites and nitrates self-poisoning cases have resulted in death, with 88 percent of individuals requiring management in a health-care facility.

Poison centers offer the following precautions to prevent sodium nitrite poisoning and advice on what to do in the event of an exposure:

1.       Call 911 immediately if an individual is unconscious, unable to breathe or seizing.
2.       Call Poison Help (1-800-222-1222) or visit PoisonHelp.org if you suspect someone has been exposed to sodium nitrite or for more information about poisoning prevention.
3.       If you or a loved one are in emotional distress or crisis, call National Suicide Prevention Lifeline at 1-800-273-8255.
4.       Avoid keeping large quantities of sodium nitrite containing products in the home.
5.       Store sodium nitrite containing products in a locked cabinet or up and out of reach of children.

Four ways to prepare, prevent, and protect against poisoning:

1.  Text POISON to 797979 to save the Poison Help Hotline as a contact in your mobile phone.

2. Save the Poison Help Hotline number, 1-800-222-1222, into your mobile phone.

3. Display the Poison Help Hotline contact number throughout your home.

4. Get Info:

·         Web: www.aapcc.org

·         Twitter: https://twitter.com/AAPCC

·         Facebook: https://www.facebook.com/aapcc

For National Poison Data or Information, Contact:

Maggie Maloney
Director, Public Education & Communications
[email protected]

 

More than sixty years have passed since Congress and President Kennedy first authorized the designation of National Poison Prevention Week (NPPW), proving that poison centers are here for the ages. There are currently 55 poison centers throughout the U.S. that provide 24/7/365 fast, free, confidential treatment advice. Each year, the specially trained pharmacists, nurses, and physicians manage more than 2 million poisoning cases. These medical experts save lives by providing essential public health information to people of all ages.

 

Poison centers, government agencies, the executive and legislative branches, and other organizations use NPPW to raise awareness about the usefulness of poison centers and the Poison Help line (1-800-222-1222). In fact, a White House proclamation for NPPW is released annually. This year’s full proclamation is available for view here. In addition, U.S. Senators Sherrod Brown (D-OH), Tim Scott (R-SC), and Richard Blumenthal (D-CT) sponsored a resolution in order to recognize the week of March 20 through March 26, 2022, as National Poison Prevention Week. “Ohio is the proud home to two Poison Control Centers and I’m grateful for the lifesaving work the workers there do to keep our communities safe. As we recognize National Poison Prevention Week, we must continue to support the work of the CDC and ensure staff, faculty, and other experts at our Poison Control Centers have the resources they need,” said Senator Brown.

 

About 90%  of poisonings happen at home. “Parents and caregivers juggle many responsibilities at home and often children have access to products that may cause a poisoning,” said Julie Weber, President of the American Association of Poison Control Centers (AAPCC). Poison Prevention Week is a great opportunity to learn about resources and establish home safety practices. A call to our medical experts will ensure that we keep families safe and prevent unintentional poison exposures. Approximately 70 % of cases managed by people who call the Poison Help line get the help they need right where they are — saving the cost of an unnecessary trip to a doctor or hospital. If you have questions or suspect you may have been exposed to a poison, a call to the Poison Help line at 1-800-222-1222 is best or use our online tool at www.PoisonHelp.org. All NPPW 2022 resources and activities are available on the AAPCC website at www.aapcc.org/nppw-2022/.

Four ways to prepare, prevent, and protect against poisoning:

1. Save the Poison Help Hotline number, 1-800-222-1222, into your mobile phone.

2. Display the Poison Help Hotline contact number throughout your home.

3. Online Poison Help: log on to www.PoisonHelp.org, the official site of the AAPCC.

4. Follow AAPCC on social:

Web: www.aapcc.org

Twitter: www.twitter.com/AAPCC

Facebook: www.facebook.com/aapcc/

 

For Media Requests, Contact: [email protected]

 

 

After recent scares of limited gasoline, some states on the nation’s East Coast have experienced severe gasoline hoarding and siphoning. The American Association of Poison Control Centers (AAPCC) joins the Blue Ridge Poison Center in warning against siphoning gasoline after receiving a notable spike in gasoline-related calls. According to the National Poison Data System (NDPS), there has been a 45% increase in gasoline ingestions between May 10-May 12, 2021. Most exposures occurred between the ages of 13-59. The majority of exposures (78%) were managed out of the hospital.

Additionally, the U.S. Consumer Product Safety Commission warned against filling plastic bags with gasoline. When gasoline is not stored in the proper fuel approved containers, it can be hazardous if inhaled. According to NPDS, inhalation resulted in 25% of gasoline exposures in May 2021.

Although most gasoline exposure calls to poison centers resulted in minimal to no symptoms, injuries can still occur by any route. Injuries may include but are not limited to the following: coughing, shortness of breath, chemical pneumonia, chemical burns, and unconsciousness.

If you have questions or suspect you have been poisoned by gasoline, contact your local poison center at 1(800)222-1222. Poison experts (nurses, doctors, and pharmacists) are available to answer your call 24/7/365.

Four ways to prepare, prevent, and protect against poisoning:

1. Text POISON to 797979 to save the Poison Help Hotline as a contact in your mobile phone.

2. Save the Poison Help Hotline number, 1-800-222-1222, into your mobile phone.

3. Display the Poison Help Hotline contact number throughout your home.

4. Get Info:

Web: www.aapcc.org

Twitter: https://twitter.com/AAPCC

Facebook: https://www.facebook.com/aapcc/

For National Poison Data or Information, Contact:

Yasmine Harding, MS, CHES®

Director, Public Education & Communications

[email protected]

News

U.S. poison control centers have reached an astonishing milestone: 1 million COVID-19 cases. The free services offered through the Poison Help Hotline (1-800-222-1222) remain vital in public health efforts to respond and answer questions related to information, preventative measures, and vaccines for COVID-19 cases. When medically appropriate, the treatment advice provided by specially trained professionals keeps patients at home, saving millions in medical expenses.

Poison center specialists have increasingly responded to information and chemical exposure cases related to cleaning and disinfecting products, including hand sanitizer. Centers have also assisted local health agencies by providing triage services through local COVID-19 Hotlines.

New Jersey was one of the first states impacted by the devastating effects of the Coronavirus. “Although we’ve operated many emergent health hotlines in the past, none would compare to the challenges that lay ahead. Calls to the hotline exceeded initial expectations. Volume quickly soared and remained at unprecedented levels for months on end”, said Dr. Diane Calello, Executive and Medical Director of the New Jersey Poison Control Center at Rutgers New Jersey Medical School. “We were receiving around 1,000 COVID calls a day up until the beginning of summer. Throughout the year, we’ve continued to experience intense surges in call volume requiring every member of our staff to ensure the hotline remained accessible to those in need”, said Dr. Bruce Ruck, Managing Director of the New Jersey Poison Control Center at Rutgers New Jersey Medical School.

Surpassing 1 million cases reinforces the importance of AAPCC’s pledge to assist during public health emergencies and mitigate poisonings related to COVID-19. During the surge of COVID-19 cases, the American Association of Poison Control Centers (AAPCC) supported members with surveillance and outreach efforts to track and reduce the spread of the Coronavirus.

Four ways to prepare, prevent, and protect against poisoning:

1. Text POISON to 797979 to save the Poison Help Hotline as a contact in your mobile phone.

2. Save the Poison Help Hotline number, 1-800-222-1222, into your mobile phone.

3. Display the Poison Help Hotline contact number throughout your home.

4. Get Info:

Web: www.aapcc.org

Twitter: https://twitter.com/AAPCC

Facebook: https://www.facebook.com/aapcc/

 ALERT

Recent winter storms have left many Americans without electricity and resorting to the use of alternative equipment and appliances to heat their homes. Operating alternative heating sources can generate carbon monoxide (CO) gas.

CO gas is deadly, even though it is colorless, odorless, and tasteless. There are no warning signs specific to a CO exposure. Even when it is not fatal, CO can cause permanent damage to the brain and other parts of the nervous system. It affects people of all ages, but infants, children and those who are pregnant are even more susceptible.

Potential sources of CO gas are furnaces, water heaters, stoves, ovens, kerosene space heaters, wood and gas fireplaces, wood-burning stoves, portable generators, and automobile engines. If there is a flame, CO is produced.

To prevent CO poisoning and CO related death, poison centers offer the following precautions:

•  Never attempt to heat your home by using an oven, clothes dryer, or automobile.
• Generators should only be used outdoors. When used outdoors, generators should be placed at least 20’ from doors, windows, and vents to avoid exposure to people residing indoors.
• Install a carbon monoxide detector on each level of your home. Check or replace the battery regularly.
• Have your home heating system and chimney inspected regularly to ensure proper ventilation.
•  Call Poison Help (1-800-222-1222) in an emergency or for more information about preventing an exposure to carbon monoxide.

Four ways to prepare, prevent, and protect against poisoning:

1. Text POISON to 797979 to save the Poison Help Hotline as a contact in your mobile phone.

2. Save the Poison Help Hotline number, 1-800-222-1222, into your mobile phone.

3. Display the Poison Help Hotline contact number throughout your home.

4. Get Info:

• Web: www.aapcc.org
• Twitter: https://twitter.com/AAPCC
• Facebook: https://www.facebook.com/aapcc/

For National Poison Data or Information, Contact:

Yasmine Harding, MS, CHES
Director, Public Education & Communications
[email protected]