The National Poisons Information Centre (NPIC) was established in 1966 at the instigation of the Department of Health and the Irish Medical Association. It was located in the Charitable Infirmary in Jervis Street and its staff consisted of a Medical Director, Dr. Joseph Woodcock, and a Poisons Information Officer, Ms. Eileen Mackey. Jervis Street had already developed a reputation for looking after poisoned patients at that time as it had the first Renal-Dialysis Unit in the country. Dr. Woodcock was the head of the Anaesthetics Department and was actively involved in the Dialysis Unit.
In 1966 Dr Woodcock and Ms Mackey developed a library of reference materials, mainly with data from the National Clearing House for Poisons Centres in Washington DC. They were also given complete access to the data which had been developed by the National Poisons Information Service (NPIS) in the UK, specifically from Guys Hospital, where Dr. Roy Goulding was director of the Poisons Centre. Dr. Woodcock and Dr. Goulding started to meet every 6 months, a form of CPD meeting, alternating between London and Dublin.
From 1966 until 1990 the Poisons Information Officer answered enquiries during office hours and nursing staff on the Detoxification Unit (St. Michael's Ward) answered enquiries at all other times.
In 1966 there were a total of 209 enquiries to the fledgling service (July to December) which increased in 1967 to 869 calls. Eleven fatalities were recorded in 1967 with detailed case histories in each case. Data collection became more detailed with breakdown of cases involving drugs, household products etc. There was a steady increase in the number of calls to the Centre until the 1980's, when they levelled out, and then started to increase again in 1989, shortly after the Centre moved from Jervis Street to Beaumont in 1987. Over the 40 year period the centre has received 304,000 enquiries and recorded 747 fatalities (0.24% fatality rate).
Dr. Joseph Tracey, another Consultant Anaesthetist, took over as Medical Director of the Centre when Dr. Woodcock retired in 1985. Ms Mackey retired in 1988 and in 1991 a second Poisons Information Officer was appointed. Since then the number of Poisons Information Officers has increased to 4.5 full-time equivalents (6 people). The Centre is also ably supported by a Clerical Officer.
Over the same period the Centre increased the hours covered by dedicated Poisons Information Officers, from 9am-5pm Monday-Friday to 8am-10pm 365 days a year. The night-time service is currently contracted out to the NPIS in the UK and we are grateful for their support. Last year the NPIS answered 2459 enquires from Ireland and 8552 enquiries were answered by our own staff, bringing the total number of calls to 11,011 for 2007.
The number of calls to the Centre peaked in 2001 at 16,000. The number of telephone enquiries has decreased since then, mainly because of the introduction of TOXBASE, the on-line clinical toxicology database which was developed by the Scottish Poisons Information Bureau in Edinburgh. In 2007 there were 10,395 enquiries to TOXBASE from Irish hospitals.
In the future, the NPIC would like to develop into a well publicised, public access Poisons Information Service, with a dedicated freephone telephone number for the general public. This type of service is the norm throughout Europe and the US and has been shown to reduce the number of unnecessary visits to the A/E departments, especially in paediatric cases. Such a service has also been used as an early warning system for toxic events, spillages or contamination (for instance, of a water supply). The service needs an expansion of its medical staff as currently there is only one doctor involved and no junior medical staff. Finally, before any expansion of the service can take place the physical infrastructure will have to be expanded.
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