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Background: A free webPOISONCONTROL app allows the public to determine the appropriate triage of poison ingestions without calling poison control. If accepted and safe, this alternative expands access to reliable poison control services to those who prefer the Internet over the telephone. This study assesses feasibility, safety, and user-acceptance of automated online triage of asymptomatic, nonsuicidal poison ingestion cases., Methods: The user provides substance name, amount, age, and weight in an automated online tool or downloadable app, and is given a specific triage recommendation to stay home, go to the emergency department, or call poison control for further guidance. Safety was determined by assessing outcomes of consecutive home-triaged cases with follow-up and by confirming the correct application of algorithms. Case completion times and user perceptions of speed and ease of use were measures of user-acceptance., Results: Of 9256 cases, 73.3% were triaged to home, 2.1% to an emergency department, and 24.5% directed to call poison control. Children younger than 6 years were involved in 75.2% of cases. Automated follow-up was done in 31.2% of home-triaged cases; 82.3% of these had no effect. No major or fatal outcomes were reported. More than 91% of survey respondents found the tool quick and easy to use. Median case completion time was 4.1 minutes., Conclusion: webPOISONCONTROL augments traditional poison control services by providing automated, accurate online access to case-specific triage and first aid guidance for poison ingestions. It is safe, quick, and easy to use., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)

Unlabelled: In 2001, a new antivenin was introduced to the United States and became widely available in the snakebite season of 2002. We investigated what impact this may have had on snakebite treatment and medical outcome., Method: The study used a retrospective review of all snakebites to humans reported to the National Poison Center Database System from 2000 to 2007., Results: During the 8 years, there were 37,760 snakebites, with a mean of 4720 bites per year. There was a 27% increase in bites reported to a Poison center for the 8-year period and an overall 13.5% increase in the use of antivenin. The 2 categories primarily responsible for the increased use of antivenin were copperhead and crotaline-unknown. Rattlesnake bites remained the category most frequently treated with antivenin with a mean 52.5% treatment rate and only moderate increase for the 8 years. There was no change in the percentage or number of patients with a major outcome (mean, 3.8%) or death (mean, 0.5%). There was a decrease in patients with a minor outcome and an increase in patients with a moderate outcome., Discussion: The new antivenin is reported to have a reduced potential for adverse reactions. This may have had a role in the decision of which snakebite victims received antivenin., Conclusion: With the introduction of a new antivenin, there has been a dramatic increase in the number of snakebite patients treated with antivenin. This has been most noticeable in snake bite categories that were less frequently treated with antivenin in the past., (Copyright © 2010 Elsevier Inc. All rights reserved.)

An analysis of the results of a national certification examination for poison information specialists administered by the American Association of Poison Control Centers is presented. The failure rate in nonregional centers was more than double that in regional centers, and presents a strong argument for regionalization. Poison information specialists with prior training as pharmacists or registered nurses performed significantly better than those who were high school or college graduates in other fields, emergency medical technicians, or licensed practical nurses. Poison information specialists in centers receiving more than 15,000 calls each year had significantly higher scores. Individual total work experience also had a small but significant correlation with score. The mean score for emergency physicians serving as a control group was 57.0% compared with 77.1% for poison information specialists. The data suggest that telephone consultations for poison emergencies are done best by those who do them on a specialized full-time basis. Calls should be referred to the appropriate regional poison control center.