Ambulance services' use of poison information in Great Britain - a retrospective records analysis of calls and TOXBASE® accesses.

Abstract

Introduction: Poison information centres advise health professionals on toxic exposures and recommend appropriate responses, preventing transfer where hospital treatment is not required. No study to date has detailed ambulance enquiries for poison information in Great Britain. The aim of this study is to describe ambulance services' use of the National Poison Information Service through helpline calls and TOXBASE^® accesses.

Methods: Retrospective records analysis of ambulance calls and TOXBASE^® accesses between 1 April 2022 and 31 March 2023 in England, Scotland, and Wales. The data were analysed descriptively with frequency statistics calculated for patient demographics, characteristics of the poisoning, and advice for transfer to onward care.

Results: There were 4,053 ambulance enquiries, representing 11.0% of calls. The rate of calls per 100,000 population was 6.9 for English, 3.2 for Welsh, and 0.4 for Scottish ambulance services. Conversely, the rate of TOXBASE^® accesses was 369.2 per 100,000 for English, 233.9 for Scottish, and 111.9 for Welsh ambulance services. Phone enquiries were mostly for intentional poisoning (2342/4053 [57.8%]) involving pharmaceuticals (3502/4053 [86.4%]). Most enquiries were benign exposures at the time of the call; Poisoning Severity Score None or asymptomatic (2256/4053[55.7%]) or Minor (1536/4053[37.9%]). Most calls resulted in advice for patient transfer to definitive care (3114/4053, 76.8%). For calls and TOXBASE^® accesses, the most common agent was paracetamol.

Discussion: Ambulance services in Great Britain commonly seek poison information to inform patient management by phone and TOXBASE^®. Calls primarily relate to intentional poisoning with advice to transfer to further care. Yet, for a quarter of cases no further care is advised which likely has a cost-saving effect. Further research is needed to explore how and when paramedics seek poison information.

Conclusions: These data emphasise the importance of ensuring poisons management advice is tuned to ambulance services' needs to ensure appropriate management and patient transfer.