he pink pills must have looked like candy to 18-month-old Gregory B, because he ate a handful of them.
They were not candy, but Glyburide tablets, a glucose-lowering agent for diabetic patients, which were left lying about by his grandfather. Mercifully, Gregory's mother noticed that the medication was missing, and quickly contacted the Long Island Regional Poison Control Center (PCC) at Winthrop, where Nurse Specialist Randi Mestel, RN, BSN, CSPI took her call.
"Mrs. B was frantic at first," Ms. Mestel says. "I calmed her down, then assessed the situation and made arrangements for Gregory to be brought to Winthrop's Emergency Department."
Without the immediate treatment Gregory received at Winthrop, his dangerously low glucose level might have produced convulsions, brain damage - even, ultimately, death. Intravenous glucose
administration restored his blood chemistry to a normal range, and ongoing monitoring in the Pediatric Intensive Care Unit assured that Gregory was recovering. He was stable by morning, and able to return home the following day.
As Gregory was discharged, his mother received detailed poison prevention information, and his grandfather was reminded to keep his medications out of the sight and reach of small children.
A Life Saving Resource
Gregory's episode was traumatic for his family, but, in fact,
Winthrop's PCC staff members
routinely save lives. Under the direction of Howard Mofenson, MD, Medical Director, and Thomas Caraccio, PharmD, Coordinator, and certified by the American Association of Poison Control Centers, the PCC is a comprehensive resource of information and advice on toxins that affect humans,
animals, and the environment.
Elderly people are at a greater risk of poisoning, because of the number of medications they take for chronic illnesses. Drug interactions are another source of their problems. Winthrop's PCC staff has also found that one out
of every five accidental childhood poisonings involves grandparents and their medications.
Serving 2.7 million Nassau and Suffolk residents, plus 36 area hospitals, the PCC provides toxicological and pharmaceutical information to callers; instructs in the First Aid management of toxicological emergencies; offers professional consultations to physicians and hospitals for serious poisonings; collects and analyzes data on toxins; and provides accurate information on poison prevention.
Utilization continues to climb each year. During l997, the staff managed more than 64,000 calls for help, a 25% increase compared to l992, prior to the PCC's association with Winthrop. Incidents relating to children under six years of age generate 52% of all calls received annually - which correlates closely with national data. Calls are also more
frequent during the
summer. Dr. Caraccio identifies the home as the most frequent site
of exposure to poison,
followed by industrial worksites.
As the PCC offers service through round-the-clock AT&T language
service, calls also come from
overseas. Last year, the staff saved the life of a little boy in Mexico who had ingested lye.
The PCC also manages animal exposures and bites, including snake bites. In late December, l997, the PCC was consulted by the Long Island Reptile Museum in Hicksville for advice on treating an employee who had been bitten by a Gaboon Viper, a West African snake. Through the PCC, arrangements were made to have the man flown to Bronx Jacobi Medical Center, the metropolitan area's regional snake bite hospital, where he underwent anti-venom therapy imported from South Africa.
The PCC also develops specialized protocols for violent or suicidal patients, and provides management input and seasonal bulletins on food poisoning and environmental hazards, such as Halloween safety, "How to Defrost and Prepare Your Turkey," and holiday decoration and toy safety.
The Center also provides information on such specialized areas as veterinary toxicology and the effect of drugs and chemicals on a
Did you know that 80% of all lead poisonings on Long Island are caused primarily by ingestion? The PCC also serves as Long Island's primary resource for the prevention of lead poisoning, with Andrea Donatelli, RN, PNP serving as Lead Coordinator. During l997, the PCC monitored 8 patients at Winthrop's Lead Clinic, 15 cases at Nassau County Medical Center, and provided 28 medical consultations.
The Center also provides free poison prevention programs for all age groups throughout Nassau and Suffolk, as well as substance abuse education. Recently, the PCC established the Long Island Injury and Prevention Center, an educational resource for health professionals and the public.
Besides publishing "Poison Perspectives," a monthly newsletter for physicians, and "Pointers on Poison" for the public, the PCC keeps hospital emergency departments informed about the latest toxicological emergencies through its bi-weekly update, "Tox Alerts." For more information, call 516/542-2323.