pitals prepare for acts of bioterrorism, outbreaks of infectious disease, and other public health threats and emergencies. For a further discussion of state involvement, see Chapter 9.
To help describe the relevant services that poison control centers can provide, the following framework is adapted from the Haddon Matrix: Preevent, including planning, education, and surveillance; Event and Response, including detection, investigation, dissemination of information to the public, antidote distribution, and communication with agencies; and Recovery, including serving as an information resource for the public and health care providers.
Preevent activities include the following:
Preparedness planning: Poison control center personnel, particularly toxicologists and pharmacists, serve in multiple capacities related to local, regional, and national emergency preparedness planning; examples include service on state and local preparedness committees and advisory groups. CDC and HRSA guidance in 2003 to state and local applicants for cooperative agreement funding for public health preparedness and response to bioterrorism specifies that poison control centers be represented on advisory committees for these cooperative agreements. Centers also assist with Strategic National Stockpile planning; help with local and regional capacity assessments related to bioterrorism preparedness; and develop diagnostic and treatment protocols and associated standardized staff education programs. Poison control centers also maintain antidote supplies and/or facilitate local/regional inventory tracking for essential medicines and other supplies.
Surveillance: Poison control centers participate in toxicosurveillance for the identification of sentinel events that may represent intentional bioterrorist events or natural toxin exposures. Every 4 to 10 minutes, poison control centers upload case data to TESS. To assist in improving public health surveillance, CDC’s National Center for Environmental Public Health, the Agency for Toxic Substances and Disease Registry (ATSDR), and AAPCC are working to convert TESS into a real-time public health surveillance system. This conversion will generate more immediate and appropriate responses to public health threats that may be related to toxins or chemicals in the environment. In addition to a national toxicosurveillance effort performed in conjunction with AAPCC, poison control centers participate in local syndromic surveillance and report notifiable conditions affecting multiple individuals to local and/or state health officials.
Continuing education and research and preparation for bioterrorism through effective training programs: Poison control centers provide training to various groups (e.g., the public, emergency medicine residents, medical toxicology