Wigder H N, Erickson T, Morse T, Saporta V
Department of Emergency Medicine, Lutheran General Hospital, Park Ridge, IL.
Ann Emerg Med. 1995 Mar;25(3):349-52. doi: 10.1016/s0196-0644(95)70293-8.
Requests for medical advice regarding treatment of poisonings are common in emergency departments. Although there are designated poison centers (PCs), most EDs are recognized by the community and medical staff as a poison information resource. The purpose of this study was to evaluate the accuracy and consistency of poison information given by ED personnel.
A prospective, stratified-sample, telephone survey over a 6-month period of requests for medical advice about simulated poison ingestions.
Fifty-two hospital EDs in urban and rural Illinois, all three PCs in Illinois, and three PCs from Indiana, Wisconsin, and Michigan.
Hospital EDs responded correctly to only 100 of 156 calls (64.2%). PCs responded correctly to 17 of 18 calls (94.4%), whereas teaching hospitals responded correctly to 15 of 30 calls (50%, P = .002). ED night shift personnel were 5.5 times more likely to respond incorrectly than were personnel on other shifts (95% confidence interval, 2.72 to 11.12). Forty-eight percent of all calls to EDs resulted in advice to call the regional PC.
Poison advice by ED personnel proved to be inaccurate and inconsistent. As a result, patients may be better served if advice calls are redirected to regional PCs.
在急诊科,关于中毒治疗的医疗咨询请求很常见。尽管有指定的中毒控制中心(PCs),但大多数急诊科被社区和医务人员视为中毒信息资源。本研究的目的是评估急诊科人员提供的中毒信息的准确性和一致性。
一项为期6个月的前瞻性分层抽样电话调查,内容是关于模拟中毒摄入的医疗咨询请求。
伊利诺伊州城乡的52家医院急诊科、伊利诺伊州的所有三家中毒控制中心以及来自印第安纳州、威斯康星州和密歇根州的三家中毒控制中心。
医院急诊科在156个电话中仅正确回复了100个(64.2%)。中毒控制中心在18个电话中正确回复了17个(94.4%),而教学医院在30个电话中正确回复了15个(50%,P = 0.002)。急诊科夜班人员回复错误的可能性是其他班次人员的5.5倍(95%置信区间,2.72至11.12)。所有打给急诊科的电话中有48%的结果是建议拨打地区中毒控制中心电话。
事实证明,急诊科人员提供的中毒建议不准确且不一致。因此,如果将咨询电话转至地区中毒控制中心,患者可能会得到更好的服务。