Vassilev Zdravko P, Kashani John, Ruck Bruce, Hoffman Robert S, Marcus Steven M
New Jersey Poison Information and Education System, Newark, New Jersey, USA.
Prehosp Disaster Med. 2007 Jan-Feb;22(1):55-8. doi: 10.1017/s1049023x00004349.
Poison Control Centers (PCCs) play an integral role in the preparation for and management of poison emergencies. Large-scale public health disasters, caused by both natural and human factors, may result in a drastic increase in the number of inquiries received and handled by PCCs in short periods of time. In order to plan and prepare for such public health emergencies, it is important for PCCs to assess their ability to handle the surge in call volume and to examine how the unusually large number of calls could affect the level of services. On 26 January 2006, the New York City Poison Center experienced a sudden loss of telephone service. The disruption in telephone service led to the need to reroute calls from that geographical catchment area to the New Jersey Poison Information and Education System (NJPIES) for several hours.
Data from the NJPIES was abstracted from the telephone switch's internal reporting system and the NJPIES's electronic record system and processed with a standard spreadsheet application.
Compared to the same time and day in the previous week, the total number of calls received by the NJPIES during the four hours after the disruption increased by 148%. A substantial rise in the number of calls was observed in almost every 15-minute increment during this four-hour (h) time period (with some of these increments increasing as much as 525%). Meanwhile, the percentage of calls answered by the NJPIES decreased, and the percentage of calls abandoned during a 15-minute increment reached as high as 62%. Furthermore, the average time for handling calls was longer than usual in most of these 15-minute increments.
Limitations of the telephone technology, which impacted the ability of the NJPIES to respond to the surge of calls, were observed. While the NJPIES was able to handle the unusual increase of incoming calls using available poison specialists and staff, the experience gained from this natural experiment demonstrates the need for PCCs to have a pre-planned surge capacity protocol that can be implemented rapidly during a public health emergency. A number of challenges that PCCs must meet in order to have adequate surge capacity during such events were identified.
中毒控制中心（PCCs）在中毒紧急情况的准备和管理中发挥着不可或缺的作用。由自然和人为因素导致的大规模公共卫生灾难，可能会使中毒控制中心在短时间内收到和处理的咨询数量急剧增加。为了规划和应对此类公共卫生紧急情况，中毒控制中心评估其处理呼叫量激增的能力并检查异常大量的呼叫如何影响服务水平非常重要。2006年1月26日，纽约市中毒控制中心突然失去电话服务。电话服务中断导致该地理区域的呼叫需要重新路由到新泽西州中毒信息与教育系统（NJPIES）数小时。
来自NJPIES的数据从电话交换机的内部报告系统和NJPIES的电子记录系统中提取，并使用标准电子表格应用程序进行处理。
与前一周的同一时间和日期相比，中断后四小时内NJPIES收到的呼叫总数增加了148%。在这四小时期间，几乎每15分钟的时间段内呼叫数量都大幅上升（其中一些时间段增加高达525%）。与此同时，NJPIES接听的呼叫百分比下降，15分钟时间段内放弃的呼叫百分比高达62%。此外，在这些15分钟的大多数时间段内，处理呼叫的平均时间比平时更长。
观察到电话技术的局限性影响了NJPIES应对呼叫激增的能力。虽然NJPIES能够利用现有的中毒专家和工作人员处理来电的异常增加，但从这个自然实验中获得的经验表明，中毒控制中心需要有一个预先计划的激增能力协议，以便在公共卫生紧急情况期间能够迅速实施。确定了中毒控制中心在此类事件中为拥有足够的激增能力必须应对的一些挑战。
