A Night at Poison Central : Specialists Have Answers That Can Save Lives, but Funds Are Running Out
The dinner hours are the worst. Not so much because the kids are hungry, but because the grown-ups aren’t watching. An 18-month-old downs a vial of perfume. A toddler swallows an acorn--or was it two?
By 8 or 9 p.m., it’s the teen-agers. A 14-year-old takes a fist full of painkillers after a fight with her mother. A 17-year-old, despondent over boyfriends and grades, gulps a bottle of Extra-Strength Tylenol.
This night, they will all be saved through the efforts of the Los Angeles County Medical Assn.’s Poison Control Center.
But who will save the center?
Unless new ways to cover rising costs are found, the region’s only poison center--which last year answered more than 50,000 cries for help--will close at the end of the year. In its absence the burden would fall completely on already overtaxed services such as 911, rescue squads and emergency rooms.
“Everyone agrees this is a wonderful, life-saving service. And everyone agrees the center must not close,” says Michael Wieland, director of the center, which relies on state and private funding. “But, so far, no one has come forward to save it.”
“My baby just took a big bite--I mean, a really big bite--out of this deodorant stick. Is it fatal?”
“No, he’ll be fine.”
“My daughter ate a watch battery a couple of days ago. What should I do?”
“Take her to the hospital for an X-ray. It could be lodged in her digestive tract.”
“My little girl drank one of those little sample bottles of perfume. Is she OK?”
“Yes.”
“We gave our 2-year-old a sample bottle of (arthritis medicine) to play with and he got the top off and ate three tablets . . . Uh, at least three. “
“Give him Ipecac immediately to induce vomiting. I’ll call you right back.”
When you call the 24-hour poison control center, the first--and only--voice you hear is that of a registered nurse, pharmacist, or other medical professional specially trained in toxicology. The 16 staffers are not volunteers--they are high-priced professionals--and they do not guess at what to say.
Their advice is based on their medical and toxicology training, their experience at the center, and the information provided by computer systems on more than 500,000 poisonous substances.
Three out of four calls are about children under the age of 7. And about 70% of all calls require no medical attention beyond that provided over the phone by the center’s staff.
Nurse Frances Weindler has been with the center for 31 years and believes that beyond saving lives, her mission is to impart understanding in the midst of self-blame and a sense of calm in the face of panic.
“Many times mothers call in and say, ‘I did something stupid,’ and the first thing we say is ‘You didn’t do anything stupid. You’re human. Now--what happened?’ ”
Fathers call too. On a recent night, Jesse Mercado called when he realized his 13-month-old daughter Jessica had eaten Mentholatum. “I heard her cough and saw she had the jar in her hand. I could smell it on her breath. And it was just like second nature, I called information and asked them for the nearest poison center,” Mercado later recalled.
“They told me whatever you do, don’t make her throw up. This is an oil-based substance and she could inhale it and suffocate. I never thought of that. I gave her her bottle like they said and then they called back during the night to see how we were doing. They calmed me down and helped me do the right thing,” says Mercado.
That same night in Castaic, another little Jessica slipped into her grandmother’s bedroom, opened a bottle of the painkiller Naprosyn and walked to the kitchen where her horrified mother saw her holding a handful of pills. The 2-year-old was munching at least one.
“I called the emergency room first but they couldn’t tell me a thing. I was scared to death,” says Jill Smith, Jessica’s mother. “I was alone with the baby. My car was broken down and I was a good distance from the nearest hospital. I don’t know what I would’ve done without the poison center.”
Medical association leaders blame the sinking economy for shrinking support by the 34-year-old service’s traditional backers--big business foundations and other private benefactors. Some critics suggest that the medical association has not been aggressive enough in soliciting funds from its own doctors, as well as from the people and institutions who use the center.
The Los Angeles center, which serves the 10 million people in Los Angeles, Ventura and Santa Barbara counties, is one of the nation’s busiest. It also is the only center run by a medical association. Association officials say they need $800,000 to $1 million a year to keep the center alive.
Two-thirds of the center’s $1.2-million current budget comes from private sources, with the balance from the state. While Los Angeles County has never been an official sponsor, County Supervisor Ed Edelman recently asked for a report on possible county aid.
But the Los Angeles poison center isn’t the only one in critical condition. Centers in Orange County and San Francisco also face money problems. With no federal source and unpredictable state support, “virtually every” poison center in the United States is running out of money, according to the American Assn. of Poison Control Centers.
When poison centers have closed in other states, most people have called 911 or their personal physicians for help. And most of them, according to recent studies, ended up in expensive emergency rooms for treatment that in most cases could have been managed at home.
“The costs of going to hospitals, or even private doctors, is exorbitant,” says the center’s director Wieland. “It will cost this county many millions of dollars in additional medical costs if the center closes its doors.”
Most calls to the poison center involve exposure to toxic household products. One mother made pancakes with Pine-Sol, thinking it was vegetable oil. Her family ate the pancakes. But the poison center saved the day.
Each year about 2,000 calls concern pets. “My dog ate a jade plant.” “My cat licked the bug killer.” Even, “We painted the house and now my canary won’t sing.”
Many calls have to do with possible poisoning from over-the-counter and prescription medications, either accidental or intentional.
“What I’m calling about is to find out when you take Valium and Elavil and lithium all together, how long does it take to kill you?” asked one recent caller, who refused to identify herself or accept offers of aid. She called back several times the same night to report that her heart was slowing down. “I don’t expect to make it,” she whispered.
The staff, unable to trace the call, urged the woman to call 911 but she said, “I guess I’ll have to ride this out myself.”
A 39-year-old photographer called the poison center that night when she tried to clear a bathroom drain. “There is sulfuric acid spilled all over the floor,” she gasped. “I can’t breathe. I can feel my throat closing up. Please, help me.”
Private doctors and emergency room staffs are frequent callers.
Nurse Karen Chacanaca, who left emergency medicine to join the poison control team, says her job is to draw a picture for emergency teams who call her “to help them see what dangers lie ahead.” Because, she adds, “when it comes to poison, sometimes they really don’t know.
“The message we put out here to everybody,” says Chacanaca, “is, ‘Hey, medicines aren’t good. They’re very dangerous. Be careful.’ ”
And maybe, be especially careful after Jan. 1.
In a letter last month to the state, medical association vice president Collette Wright warned, “Without substantial, sustained, additional contributions . . . we will have no other option but to suspend operation.”
