title: A retrospective review of 911 calls to a regional poison control center.
abstract: BACKGROUND
  There is little data as to what extent national Emergency Medical Services (EMS; 911) utilize poison control centers (PCCs). A review of data from our PCC was done to better understand this relationship and to identify potential improvements in patient care and health care savings.
  
  
  METHODS
  Retrospective chart review of a single PCC to identify calls originating from 911 sources over a 4-year study period (1/1/08-12/31/11). Recorded variables included the origin of call to the PCC, intent of exposure, symptoms, management site, hospital admission, and death. Odds ratios (OR) were developed using multiple logistic regressions to identify risk factors for EMS dispatch, management site, and the need for hospital admission.
  
  
  RESULTS
  A total of 7556 charts were identified; 4382 (58%) met inclusion criteria. Most calls (63.3%) involved accidental exposures and 31% were self-harm or misuse. A total of 2517 (57.4%) patients had symptoms and 2044 (50.8%) were transported to an Emergency Department (ED). Over 38% of calls (n = 1696) were handled primarily by the PCC and did not result in EMS dispatch; only 6.5% of cases (n = 287) with initial PCC involvement resulted in crew dispatch. There were 955 (21.8%) cases that resulted in admission, and five deaths. The OR for being transported to an ED was 45.4 (95% confidence interval [CI]: 30.2-68.4) when the crew was dispatched by the PCC. Hospital admission was predicted by intent for self-harm (OR 5.0; 95% CI: 4.1-6.2) and the presence of symptoms (OR 2.43; 95% CI: 1.9-3.0). The ORs for several other predictive variables are also reported.
  
  
  CONCLUSIONS
  When 911 providers contact a PCC about poisoning-related emergencies, a history of intentional exposure and the presence of symptoms each predicted EMS dispatch by the PCC, patient transport to an ED, and hospital admission. Early involvement of a PCC may prevent the need for EMS activation or patient transfer to a health care facility.
authors.affiliation: Department of Medical Toxicology, Banner - University Medical Center Phoenix, Phoenix, Arizona, USA; Center for Toxicology and Pharmacology Education and Research, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Bosak
authors.affiliation: Banner Poison and Drug Information Center, Phoenix, Arizona, USA; Department of Medical Toxicology, Banner - University Medical Center Phoenix, Phoenix, Arizona, USA; Center for Toxicology and Pharmacology Education and Research, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Brooks
authors.affiliation: Banner Poison and Drug Information Center, Phoenix, Arizona, USA; Center for Toxicology and Pharmacology Education and Research, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA.
authors.forename: Sharyn
authors.initials: S
authors.lastname: Welch
authors.affiliation: Department of Medical Toxicology, Banner - University Medical Center Phoenix, Phoenix, Arizona, USA; Center for Toxicology and Pharmacology Education and Research, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA.
authors.forename: Angie
authors.initials: A
authors.lastname: Padilla-Jones
authors.affiliation: Department of Medical Education, Banner - University Medical Center Phoenix, Phoenix, Arizona, USA; Center for Toxicology and Pharmacology Education and Research, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Gerkin
keywords: 911 triage; emergency medical services; poison center