title: Impact of the Use of Regional Poison Control Centers in an Urban EMS Dispatch System.
abstract: The public commonly calls 911 for unintentional ingestions, rather than calling the local poison center. By utilizing a series of scripted questions, 911 dispatchers in Los Angeles determine if an ingestion meets "omega-1" classification. Under such circumstances, the regional poison center is contacted prior to dispatch of paramedics. If the poison center advises that the patient can remain at home, EMS is not dispatched and the patient is followed at home by the poison center. The primary objective is to determine the number of averted transports through involvement of a poison center. A secondary objective is to determine the potential costs and charges saved with the use of such a strategy.
  
  
  
  A retrospective review of all overdose calls with an "omega-1" classification to a single EMS system between 1/2008-6/2012. Each call culminating in an EMS dispatch was subsequently reviewed by two additional reviewers. The cost savings was determined by utilizing data from the Medical Expenditure Panel Survey (MEPS) from 2000 to 2010. Monetary values were adjusted to 2012 dollars.
  
  
  
  Three hundred eighteen cases received "omega-1" dispatch classification. EMS was dispatched 19 times (5.98 %), and 11 patients (3.46 %) were ultimately transported. The most common reasons for transport were ambiguity over the ingested agent or amount, and caller insistence. Using these estimates, routine consultation of a regional poison center as part of EMS dispatch averted $486,595 in charges, and $183,279 in payments.
  
  
  
  Routine consultation of a poison center by emergency medical dispatchers can reduce unnecessary dispatches, ambulance transports, and ED visits with significant associated cost savings.
authors.affiliation: Department of Emergency Medicine, Division of Medical Toxicology, University of Southern California, Los Angeles, CA, USA. mdlevine@usc.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Levine
authors.affiliation: Los Angeles City Fire Department, Los Angeles, CA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Flores
authors.affiliation: Department of Emergency Medicine and the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Seabury
authors.affiliation: Los Angeles City Fire Department, Los Angeles, CA, USA.|Department of Emergency Medicine, Division of Emergency Medical Services, University of Southern California, Los Angeles, CA, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sanko
authors.affiliation: Los Angeles City Fire Department, Los Angeles, CA, USA.|Department of Emergency Medicine, Division of Emergency Medical Services, University of Southern California, Los Angeles, CA, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Eckstein
mesh_terms: D000488:Allied Health Personnel; D017046:Cost Savings; D062787:Drug Overdose / Q000145:classification* / Q000191:economics / Q000628:therapy; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles; D011039:Poison Control Centers / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012189:Retrospective Studies
keywords: Cost; Dispatch; EMS; Paramedic; Poison control center