For 50 years, the Maryland Poison Center (MPC) has provided worried parents, families, and individuals with expert medical advice on treatment, prevention, and education. Housed at the University of Maryland School of Pharmacy (UMSOP), MPC is certified by the American Association of Poison Control Centers as a regional poison center. Bruce Anderson, PharmD, DABAT, professor, Department of Pharmacy Practice and Science, UMSOP, and executive director, MPC, and Angel Bivens MBA, CSPI, assistant director, operations and public education, MPC, join “The UMB Pulse” to talk about what kinds of guidance the center provides to the public (0:16) and medical providers (3:04), celebrating 50 years (8:02), and social media challenge disasters (18:54), as well as to answer what’s really on our minds: Is Mr. Yuk still a thing? (15:12). Listener discretion is advised.
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You're listening to the heartbeat of the University of Maryland, Baltimore, the UMB Pulse. Welcome to the UMB pulse. I'm Charles Schelle. I'm Dana Rampolla. And I'm Jenna Frick. All season long the Pulse has been featuring stories about people and programs that are making a significant difference whether it's in Maryland on a national level or even a global level, this month change maker as the Maryland Poison Center, which is celebrating 50 years of helping Marylanders needing first aid advice for toxic exposures. And the center is housed at the University of Maryland School of Pharmacy, and it's certified by the American Association of Poison Control Centers as a regional poison center. It's available 24 hours a day, every day of the week and can be reached at 1-800-222-1222. And we should note that the topics that we're discussing today of ingestion, and healing or exposure to certain substances can be sensitive to some listeners that may not be appropriate for children. listeners should use their own discretion if they decide to continue to listen. And moving on joining us on the pulse our University of Maryland School of Pharmacy professor and Maryland poison center director Bruce Anderson, and Assistant Director, Angel Bivens. Welcome to the show. Thanks for having us. What does the Maryland Poison Center do and who in Maryland can use it? So the Maryland Poison Center is an emergency telephone information service. And we're available to everybody. And it doesn't matter if it's a, I don't know, a mom at home that that their two year old was in air quotes, helping them with laundry and ended up spilling bleach all over themselves. Or if it's somebody who has taken a ridiculous Tiktok challenge and done something incredibly stupid. Or if it's, gosh, we've even gotten calls from people about their pets getting into things. We're not an animal poison center, but we try and help people out. We get calls from everybody about everything. I also happen to be a scout leader. So imagine you're out on a trail and you step over a log. And on the other side of that log happen to be a snake that was sunning itself, and you get bitten. Who do you call? You call the poison center. You have an occupational exposure, something at the workplace, you know, if they're a mechanic happened to be, you know, looking under the car that he was fixing, and align broken, some gas dripped into his eye, who you're going to call 800-222-1222. You'll get connected to a health professional with experience in dealing with exactly those kinds of situations. And that phone number works anywhere in the nation, and they'll direct you to the right poison center. Right? We hope so. Yeah. When someone calls the Maryland Poison Center, who's on the other side of the line, who do they get to talk to? The people answering the phones are pharmacists and nurses, and they have a special training in toxicology, or the study of poisons and treating poisoned patients. So they go through rigorous training, and are truly experts in providing the best possible advice. And do all medical providers instantly know that they can reach out to the Maryland Poison Center? Or is this something that you're trying to build awareness of. We are absolutely trying to build awareness. There are new folks that are trained every year and not every institution that trains health care providers, includes a lesson on you know how to reach the Poison Center and know that this is a service that's available. So we're doing what we can to try and make sure not only health providers, but everybody knows who we are and what we do. Well, I appreciated you saying the part about snakes because I'd never would have thought to have done that. I would think certainly somebody got into something under my sink but not about a bite. So this is great information. How about spiders? How about, you know, it doesn't matter what the substance is or what the exposure is, give us a call. We'll be happy to try and help And at least direct us if you can't to where we can get answers. Exactly. Food poisoning. Yeah, and any number of things. That's great. You get a bump in calls every year on the last Thursday of the month in November, or yes in November. Very, very specific. Yeah. People gett stuff for Thanksgiving? Is it usually about the same thing? We see a spike in calls about about food poisoning related to Thanksgiving turkey. People that inadvertently cooked the turkey with the giblets inside or people defrost to the turkey in time and again we're not the Butterball hotline. We wish we were the Butterball hotline but but we're a resource and people think food poisoning -- poisoning -- call the poison center. I at least hope, hope they do, certain people do. But we see certain spikes over time in in calls just like that. So around Thanksgiving, we hear about food poisoning around the Fourth of July. We have a glow stick, you know so any number of exposures to glow sticks, kids biting them, kids spinning them around so that they break and get the stuff in their eyes. Or their older siblings eyes or mom's eyes. So we get a lot of calls about glowsticks on the Fourth of July. So that's interesting. And you kind of answered my next question, which is, do your calls change throughout the year? So it sounds like there are specific times where you're getting specific things. And then other things just filtered in. Absolutely. So the thing seasonal, so now we're in the spring, and it we're starting to garden. And so we'll get more calls about things outside berries and plants and things like that. You know, people when they open their pools will get calls about the pool chemicals and things like that. So it is very much seasonal. As far as types of calls. Makes sense. And we're being very general about things because one of the things we learned from the poison center is that the advice is very specific. It absolutely is. And that's one of the reasons why we recommend folks call rather than looking things up on the Internet, right? Because we provide very specific information for that circumstance. So we ask about past medical history and things like that. And so we tailor our advice to that individual's specific health care situation and that specific situation as it's happening. Which is also why, as Dana said, it's important for medical providers to call and to get that technical expertise. Absolutely. It's also great that you're talking to a real person, when you call the number, which I'm sure is very refreshing. And that is the big thing is we do not have a phone tree, which is one of the more refreshing things out there, right? You get the recording, letting folks know you reach, you reach the poison center. And then the very next voice you hear is a real live poison specialist pharmacist or nurse that is there to help you. So it's not press one for this press two for that it's a live person right away. Pressing 0 five times and hoping that you reach someone Oh my god. Well, in addition to it's a real person, it's a real health care professional, right? This is somebody that 40 plus hours a week, this is what they do. And what is the average duration of experience in the poison center? Well, I think total experience all everybody combined is over 250 years. Wow. How many people would you think work in the poison center? So 24 hours a day, seven days a week? So how many people total? 100? It's a little lower. Lower than that? 75. A little lower than that. I'm gonna say 51. We have 12 full time equivalent employees to staff 24 hours a day, seven days a week. Oh, wow. Twelve, people? Yes. Wow. Amazing. How do you do it? It's challenging. I mean, especially in this period of time, when you know, people are not only potentially exposed to COVID themselves, but they may be taking care of other other family members that are sick. So it's exceptionally difficult. But the folks that do this are, are very dedicated and experts at what they do, and we managed to get it done. Yeah. So the Maryland Poison Center is featured in the latest digital issue of UMBs. Catalyst magazine with a great look back on your last 50 years. So during your 50 year history, you've seen a lot of public health concerns. What are some of the more memorable ones that the center has helped with? Well, we had the what the Tylenol tainting, I believe is what they're saying with cyanide Tampering, tainting intentional contamination. That was 1980. Something like that. Yeah. We had the tunnel fire or the train kind of tipped over and spilled chemicals. In the Howard Street Tunnel Yep. So that ended up in the environment. So we had a lot of people concerned about that. When West Nile Virus was out there, the health department or the Department of Environment would go through neighborhood spraying pesticides. That caused a flurry of calls, because people were very concerned. What's being sprayed in my neighborhood, is this going to be a problem? So we we did manage a lot of calls. And it ended up being a great working relationship between the poison center and the local health departments. They would then warn us when they were spraying so we could be ready and they would tell us what they were spraying. So we had the answers ready at hand. We've been involved in so many different things over over the years. I mean, in 2018, there was this outbreak of severe bleeding in people that were using synthetic cannabinoids. Things like that were marketed as alternatives to marijuana or cannabis that happened to get contaminated with something that's very much like warfarin, a medicine used as a blood thinner except it's much more potent and lasts much longer. And so I mean, that was a huge problem in 2018. Do you remember the the company that sent out the product that was a lemon dish detergent. But it looked like lemon juice? Yeah, I think that the it was what Sun -- Sunlight dish detergent. They sent out sample packets of it in the mail in the mail. Covered with lemons? Well covered with lemons and yel- yeah - yellow in color. And so we had a number of people that, you know, kind of season their fish and that with this dish, so again, no harm, but take the screen back when Yeah, exactly. Yeah. How long ago was that? That was the late 80s, 80s. Okay. I remember, one of the more recent ones was what the anthrax scare, right? Going through the mail of mysterious powders. In 2001, there were in one of the mail handling facilities that serves Congress happen to be located in Maryland. So the letters went through that mail handling facility and in the process of sorting the mail through all that machinery that created or provide the opportunity for some of those spores to leak out. And so there are a number of postal service employees in Maryland that were impacted by this that needed antibiotic prophylaxis. But the concern that was raised by this, oh my gosh, anthrax is in the mail caused our call volume to spike. There are certain days where we had so many calls, we couldn't actually document them. Well. It was it was a huge deal. You know, and then not only And then COVID-19 too, I could dealing with the patients that were truly exposed, but then the concerned folks that there was white powder in the in the break room that was exposed to anthrax? Well, probably not, it was probably just somebody that spilled some sugar and didn't clean it up. But that doesn't mean that we're not getting calls and that their fears weren't real. So our folks had to go ahead and kind of decrease the temperature on on the callers and defuse the situation and reassure them that it was going to be just fine. imagine between people trying to use off label uses for potential cures, or just the the obsession of spraying everything down. Yeah. So interestingly, we take a look at our data and and monitor the top five exposures each year. And in the two years of the pandemic, household cleaning products ended up in the top five list for all age groups, just because the cleaners were out and about and people were using them. And, you know, little kids were getting into them. But folks were getting stuff kind of splashed in the eyes or, you know, not washing their hands and then touching food and then worrying about ingesting it and things like that. So we we did have an increase in calls about cleaning products and hand sanitizers and things like that. We diffused all kinds of misinformation. You know, depending on what was talked about in the news that morning. I remember the morning that it was suggested that maybe we could go ahead and use bleach internally to take care of COVID. And I looked at my husband, I'm like,uh oh, I need to get ready right now. It's gonna be a busy day. And it was. I had a lot of people calling about that. Wow, it's so interesting. I wouldn't have even thought of that, you know, but this is what you deal with every day. And 12 people are dealing with all of that And not 12 people at a time, right? Well, people that have to cover the service 24/7 Yeah. And so like when when things like this happen when you have, you know, an anthrax scare or ingesting bleach or things like that it can be it can be pretty scary for the people calling in. What's the emotional journey like for the poison center staff who answers these calls? I'm not exactly sure how to answer that. Most of the folks that work in the poison center have been there, well, they're not fazed by much. There really are, I guess the job provides opportunities to learn about a whole bunch of different things and to take a slightly different perspective on the world then maybe other people do. And so there isn't much that that rattles the poison specialist. So it's just another just another day. That's probbaly very reassuring for everyone who calls. It's amazing that when we do hear back from people that provide us with feedback on their experience with speaking with a specialist, far and wide that is the first thing people said they were so nice. They were so reassuring. I felt completely calm after I was done talking to them just because I thought they knew what they were talking about. But they were so calming. Yeah, it's not like you're calling somebody and they're reading off a flowchart. And you know, following somebody else's, you know, pre-outlined directio. You're really is telling me about what's going on with your specific situation and we'll figure out what to do. Next. Sounds like these people are very smart, just to be able to dive in. They absolutely are a great group of people. We hire, we try and hire really good people and train them really well and let them do their job. Well, let's pivot for a minute. I grew up in a time where I used to see a little green sticker that had a tongue sticking out and we called him Mr. Yuk, what what's happening with Mr. Yuk is Mr. Yuk still around? Mr. Yuk actually turned 50 last year, so he celebrated his birthday. So yes, Mr. Yuk is still around. He was much more popular in the early 70s. Whenever he first started, I think there's probably only six or seven poison centers in this country out of 55 centers that still use Mr. Yuk. Maryland is one of them that still uses Mr. Yuk. And that's largely because so many people like you remembered him. And it that's part of our identity. So it's pretty hard to, you know, do away with something like that. So Mr. Yuk is still alive and well here in Maryland. And our you know, you can access the stickers on our website. And building on that, why is it important to still use Mr. Yuk especially for maybe an elder or senior population? You know, it's interesting. Mr. Yuk originally started out to warn children. Because that green color was pretty obnoxious and pretty just yucky, yucky. Back in the day, but now kids seem to be attracted to that. So not be the best tool to use to keep kids away from things, but it's very bright. And if you're an older adult living in a smaller apartment, or something like that, and have a limited space to store things, you know, it's really good idea to go ahead and maybe put a Mr. Yuk sticker on the Comet cleanser that might be stored in the same cabinet as your parmesan cheese. Be kind of a bad thing if you're sprinkling the Comet cleanser in your spaghetti sauce. So that would just kind of be Oh, that's not the one that I want to grab. Makes sense. Something familiar to them? Identifiable. So. So older populations are people that may, you may want to have call the Maryland Poison Center for one reason or another. Can you talk a little bit more about that? If you think about the number of medications that most older patients are taking it, first of all, it can be a lot to try and manage. So again, we have pharmacists and nurses that work in the poison center, so they can help with with common medication questions. But also, those older adults are not only you know, dealing with their own health issues, but they have little kids coming over and the grandkids to come and visit. Or they may have their children come by who are our adults helping with their medication management. But what happens if, say that pill a day container that contains a week worth of the medications gets spilled. And the parents are not the now grandparents are not really sure about which medicines I'm supposed to take on which day, they can call us to help identify the tablets or capsules to help them figure out how to reset that that pill a day container or to deal with whatever kinds of things happen to come up. The poison center is truly a resource for everyone. It's not just resource for people with little kids, anybody and everybody should have the phone number at the ready, You can pre program it in your in your cell phone, and that way you have it no matter where you are home vacation, whatever, you should just have the phone number on in your contacts. And there's a number you can text right to get that programmed? You can if you text the word poison p-o-i-s-o-n to 797979. It will go ahead and send you a V card that you can just go ahead and save in your phone. And there you have it Easy peasy. Perfect. Now moving to the younger generations in modern times social media challenges. You mentioned TikTok earlier, and I'm sure it provides an education for parents as well as the children in all the unknowing ways you can harm yourself. You have you know, between cinnamon and Tide Pods, probably vape juice, even whipped cream cans. What do you do about these scenarios when when they pop up? So we do what we can to try and learn about whatever the latest things are and then do education and outreach to try and make sure people know this really isn't a good idea to do. So we have an active social media presence with I don't know if we have a TikTok presence. We don't have a TikTok but we have Facebook, Twitter and Instagram. So we do what we can to get the word out about whatever the ridiculous thing is that happens to be going around today or tomorrow. And we want parents to know that you know a lot of people automatically think okay, I know to call when my little kids get into things. We want parents of those tweens and teens to know we're on your side. We are there to kind of get you up to speed with what your teens and tweens already know. Okay, so you know, don't lose our phone number we are there to help you. You know, we, I had a call from a mom, once. She found a large number of the dust off air cans in their in her son's bedroom. She said, could you give me a really good reason why he would have multiple cans. And I said, I can give you a couple reasons, probably not, you're not one you're gonna want to know. But it was good that she thought to call us. And we could go ahead and help and give her advice on how to deal with the situation. And it's probably better for her to know what is probably going on rather than just he's got a really dirty keyboard. Yeah. Exactly. Also in the house, are pets, and actually on social media, too. Every pet has an account, too. They do. So you mentioned that obviously you can't call the Maryland Poison Center for pets. But if someone does, what happens? We're very much depends on the situation. For common things in common animals, we can provide some general guidance. We are not an animal poison center, we do we can to help out. There is a national animal poison center. They want your credit card when you call. And so sometimes people are a little reluctant to give the credit card. If they just need to know is this something that's a big deal? Yes or no. And sometimes we can help with that. But again, we're not experts in dealing with animals. We do what we can to try and help people out. Right. And I think you mentioned there's like an ASPCA runs of runs a hotline for pets too. There are actually two poison centers for pets. And our specialists happily give out both phone numbers and folks can go ahead and give him a call. And yes, they do charge the fee that they charged is definitely less than a vet visit though, right? So a lot of times pet owners are willing to go ahead and pay the fee. So and we do have a great working relationship with the veterinary toxicologists, they work with the the Association of People Poison Centers, to provide education and things like that. So I should add to as a dog owner, check with your vet to see what kind of access they have through their their apps. My vet is part of like a larger association, and they used to charge but now there's like free texting where I had like text in the middle of the night, like, you know, my dog ingested this is you know, what's going on? Or what should I do, and it's just instantaneous, you know, feedback from a veterinarian. So they're modernizing too fortunately to help kind of avoid those, you know, concerns about cost or what have you. Taking it back just a little bit about, you know, education for parents and outreach on social media. So we talked about this as social media, but what other types of outreach and education does the Maryland Poison Center? Do? Can organizations actually request to have you all come out to health fairs and things like that? We actually have a request form available on our website. Folks, can you know, go www.mdpoison.com. Click on the button that for events, Bruce mentioned that we cover 4.1 million people. So we have one educator that does that. So she's very busy, and is starting to get back out into the community. She was at an event yesterday, she's at one this weekend. Yes, we try to do as many as we can. If we can't attend in person, we always offer to send materials. So we have brochures and stickers and magnets and things like that, that we can send out to events. Our website has a ton of information, including downloadable information sheets, and things like that. She's been to every corner of Maryland, from Ocean City to Oakland. Absolutely. So just to wrap it up. What for you too is your favorite part about going to work at the Maryland Poison Center every day? For me, it's just that knowing I'm helping people. I have the ability to help somebody who is in a stressful situation and being able to give them the right answer right away and help them out of whatever situation. Not to mention the the people they are a great group of co workers. So you know, it's it's fun to go to work just to be around the folks. Absolutely. In addition to that we we get the opportunity to not only directly impact people's lives, that our callers. W e also are very, very involved in training the next generation of medical providers. So obviously, we're located in the School of Pharmacy, so we see a lot of pharmacy students, and it's a rotation option for students in their last year of pharmacy school to spend five weeks with us to learn how to take care of poisoning patients, but we also are part of the training programs for many medicine residency programs emergency medicine, pediatrics, family practice, etc. As well as other programs around the state. So a lot of individuals come through our center, either in person or virtually, to get the experience of trying to deal with all of these different types of poisoning questions and learning for themselves how to manage these patients. But also learning there's this other resource that I can call, just in case there's something either that I don't know about, or I just want to make sure that it's reported, right, because every time somebody calls us, we record that case, we have documentation about that we can follow up on those patients and make sure that we have a good idea what happens to people when they get poisoned, because right now, we can't poison people prospectively, right. The IRB is not going to allow us to do that. It would be, it would be inappropriate. So we have to really do a lot of research to try and collect information to see what happens when people get exposed to things to really closely evaluate what happens when different therapies are tried. So so they're there, we're continuing to learn how best to manage poisoning patients. Yeah, and there are so many ways to learn more about the Maryland poison center beyond just calling it an emergency, you can visit the website at mdpoison.com, where you can subscribe to their newsletter, download resources, and so much more. And you can also always follow the Maryland Poison Center on social media via Facebook, Twitter, and YouTube. If you do have a poison emergency, you can call let's hear that number 800-222-1222. All right, great. Thank you, Bruce, and Angel so much for coming on and talking to us today. Thanks. Thanks for having us. During the summer, the Pulse we'll take a break from our Change Maker series to highlight some of UMB's cultural landmarks. For our July episode, the Pulse will feature UMB's original building still in use today Davidge Hall. The National Historic Landmark opened in November 1812 and is the oldest building in the Western Hemisphere continuously used for medical education. Davidge Hall executive director Larry Pitrof will be our guest. That episode will drop on our usual First Friday slot so look out for it on July 3, just in time for a little Independence Day road trip. Thanks again to Bruce Anderson and Angel Blevins from the Maryland Poison Center for appearing on the program today. And please subscribe to the UMB Pulse on Apple Podcasts or wherever you like to listen and find us online at umaryland.edu/pulse. Thanks again for listening to the UMB Pulse The UMB Pulse with Charles Schelle, Dana Rampolla and Jenna Frick is a UMB Office of Communications and Public Affairs production. Edited by Charles Schelle sound engineering by Jenna Frick marketing by Dana Rampolla. Music by No Vibe. Recorded in the University of Maryland Baltimore Community Engagement center