Long-Term Care Survey Alert

Here's how to avoid dialing up a liability disaster.

Every minute counts when a resident has had a poison exposure. That's why you need a policy and procedure up front for identifying and handling such emergencies.

Start by casting a wide net for defining what constitutes a potential poisoning. "Poisoning can include anything that the person drinks, gets on her skin or in her eyes -- or inhales," says Karen Simone, PharmD, DABAT, managing director of the Northern New England Poison Center in Portland, ME.  "That definition includes medication errors where a person received the wrong medication or too high of a dose of ordered medication  -- and it includes substance abuse," she adds.

Staff should also know the first place to call when they discover a resident has suffered a poisoning accident -- and if you think it's the resident's physician, hold that thought. "If the patient is having trouble breathing or you can't wake him up, call 911," advises Simone. "Beyond that, dialing the 1-800-222-1222 nationwide poison center number is a good first call to make."

The facility should contact the poison control center for advice when a resident has a poison exposure, agrees Cindy Bridgham, RN, risk management coordinator for Maine Medical Center in Portland, ME. Post the poison control number prominently in the medication room, on the medication cart and at the nursing station, at a minimum. "The Centers for Disease Control & Prevention is trying to disseminate the toll-free number," adds Simone.

The poison control center can tell the staff whether the person needs to go to the hospital by ambulance or they can safely monitor the person in the facility -- and what to look for, says Simone. "The consultation doesn't take the place of physician notification and intervention, however," she adds. The physician will know the resident best, but the poison control center is the expert about the poison, Simone notes.

Hold the syrup of ipecac: The recommendations for using syrup of ipecac are mixed, although most everyone has been phasing it out, says Simone. "There's a question about its efficacy," Simone explains, "and it can also cause harm when you give it to someone who ingested a corrosive substance, such as a cleaning fluid."