Posters IV - The American Academy of Clinical Toxicology

drug-related calls were transferred to us in the interest of optimal patient care. We present data that shows
this collaboration to be temporally associated with a significant change in the number of calls categorized
as TEs and ADRs. Methods: As part of a quality assurance project, the annual poison center statistics
were generated from the electronic database, Visual DotLab. The increase in TEs and ADRs was noted;
the same statistics generated from 2008 were then compared with 2010 statistics. No statistical analysis
was performed. Results: The following compares the number of calls in 2008 with 2010 (before and after
implementation of the nursing advice line): the total number of ADRs increased from 69 to 406. The total
number of TEs increased from 639 to 1063. In terms of outcomes, moderate and major effects from ADRs
increased from 9 to 71, and for TEs, from 15 to 35. The most common drug category implicated in ADRs
was antimicrobials, and for TEs, hormone and hormone antagonists (eg insulin). Conclusion: The
increase in drug-related errors and adverse reactions described may not be exclusively related to the
collaborative relationship with a new nursing advice line. However, cited reasons for the general increase
in reported TEs and ADRs, such as polypharmacy, an aging population, or co-morbidities, would be
unlikely to change significantly in such a short time period. Collaborative partnerships with other health
care agencies may improve capture of therapeutic errors and adverse drug reactions. Poison Centers can
provide valuable data that may guide preventive strategies and improve patient safety via enhanced postmarketing
surveillance.
259
Stewardly use of Rabies Post-Exposure Prophylaxis in a Time of Shortage with Triage by a Regional
Poison Center
Rachel Gorodetsky 1 , Brent Morgan 2 , Stephanie Hon 1 , Robert Geller 3
1 Georgia Poison Center 2 Emory University, Atlanta GA 3 Emory University Department of Pediatrics,
Atlanta GA USA
Background: Through an agreement with the state Public Health Department, in 1994 our poison center
began to host the state's rabies hotline through our call center, providing the invaluable service of triage
for rabies post-exposure prophylaxis (PEP). Since its inception, the service has averaged 1,400 calls
annually. Beginning in 2008, a shortage developed during which rabies vaccine was not being produced.
Existing vaccine was stockpiled by the state, and a protocol was put in place wherein a recommendation
was required from the poison center before vaccine could be released for administration. The poison
center received a new code word from the state each week, and if rabies PEP was deemed appropriate, the
provider was given the word, which allowed access to vaccine from the stockpile. In 2009, the shortage
ended, and the restriction on use was lifted. Excepting this period of shortage, poison center authorization
has not been required to administer PEP. Methods: A retrospective study was designed to evaluate the
effect of the protocol that was enacted during the shortage. The poison center's database was accessed to
obtain information pertaining to rabies exposure calls for the year of the restriction, as well as the years
immediately before and after for comparison. Results were examined for the total number of human rabies
exposure calls the poison center received, as well as the number of times that PEP was recommended.
Results:
Time period Calls received Rabies PEP recommended (%)
May 1 2007 - April 30 2008 1356 436 (32.2%)
May 1 2008 - April 30 2009* 1758 554 (31.5%)
May 1 2009 - April 30 2010 1698 567 (33.4%)