Poisindex^Óis an excellent static source of toxicologic information.  This resource can provide you with information on ingredients contained within the product as well as options for the assessment and management of the patient exposed to the individual ingredient or substance.  POISINDEX lacks the ability to interpret  lab and physical exam parameters which are customarily used to adjust therapy and accommodate the specific needs of the patient.  It also does not help in the interpretation of synergistic, additive or antagonistic effects resulting from exposure to multiple agents.  Likewise, many of the online toxicology resources suffer from the same limitations, or mor importantly are not kept up to date or accurate. Poison Center staff and toxicologists handle approximately 150-200 toxic exposure cases per day and have developed an expertise in this area.  This expertise can be called upon to assist you in making diagnostic and therapeutic decisions in both known and unknown venues.

At the national level, there are currently 55 poison centers in the U.S. which are accredited by the American Association of Poison Control Centers, the national agency which certifies poison centers based on standardized criteria and administers a certification examination for the "Specialists in Poison Information" who work in these centers.  So there may be differences between accredited and non-accredited centers by virtue of the accredited center attaining and maintaining/exceeding a baseline standard of practice.  However, some centers may provide levels of service above the required standards relating to education/training, on-call services, quality improvement modalities, research, services to industry, etc.  This is not to mean there are good vs. bad accredited centers...just that poison centers will have a "personality" much like practitioners.  We promote the policy of "getting to know your poison center" and invite all practitioners who utilize our services to visit and spend some time to get to know us.  We strive for you to have confidence in our abilities.

Specialists in Poison Information (SPI's), those individuals who provide the first line of care in our system, can be pharmacists, nurses, physicians or physician’s assistants.  Once hired, the new specialist is given approximately 40 hours of didactic work and 4-6 months of supervised clinical training.  During the training period every case handled by the new specialist is reviewed, as are the audio recordings of their case interactions.  Training programs are individualized and geared towards what the specialist needs.  As confidence and competence are built, higher acuity level cases are authorized to be handled.  Of note, the Specialists are never alone in that there is always a board-certified toxicologist available 24 hours a day to discuss cases if the need arises.  At the end of 2000 hours experience and the handling of 2000 cases, the SPI becomes eligible to sit for the national SPI certification examination administered by the American Association of Poison Control Centers (AAPCC).  They must pass this examination within 2 years of hire to continue to work in our Center.  The successful completion of the examination confers the title of "Certified Specialist in Poison Information" or CSPI.  The CSPI must undergo recertification by reexamination every 7 years.  By AAPCC center certification criteria, the managing director must be board eligible or board-certified in toxicology by the American Board of Applied Toxicology (ABAT) for non-physicians or the American College of Medical Toxicology (ACMT) or its predecessor, the American Board of Medical Toxicology (ABMT), for physicians.  The poison center medical director must also be board-certified by one of the above agencies for physicians, or have grandfathered in under specific criteria.  FPIC-Jax has three board-certified toxicologists; two by ABAT and one by ACMT.

There are a couple of different board certification routes in clinical/medical toxicology.  For physicians with a background in toxicology, an exam is given by the subspecialty boards of American Board of Emergency Medicine (ABEM), American Board of Preventive Medicine (ABPM), or the American Board of Pediatrics (ABP).  Criteria to sit for the examination vary among these groups.  The American College of Medical Toxicology (ACMT) is a professional, nonprofit association of physicians with recognized expertise in medical toxicology. The College is dedicated to advancing the science and practice of medical toxicology through a variety of activities.  For non-physicians, a board-certification examination in clinical toxicology is administered by the American Board of Applied Toxicology (ABAT) under their parent organization the American Academy of Clinical Toxicology (AACT).  To credential for this examination you must be a graduate of a college or university with an earned doctoral degree in a biomedical discipline. Applicants for diplomate status in ABAT without doctoral degrees must possess a baccalaureate degree in a health science discipline, such as pharmacy or nursing, followed by a minimum of five years of full-time professional experience in applied clinical toxicology. The ABAT exam requires a credentialing process prior to examination to evaluate each applicant in the areas of clinical, research and teaching activities, and leadership in the field of toxicology.  Twelve months of post-doctoral fellowship or 3 years of toxicology experience is required.  The designation awarded upon successful completion of the credentialling and examination process is "DABAT" (Diplomate of the American Board of Applied Toxicology).

The poison center staff will be able to provide initial assessment, triage, management, and  monitoring recommendations.  In addition to specific information on the toxin in question, detailed information on antidote use, monitoring and availability are also part of our mainstream service.  We can also help with identification of the animal, plant, insect or tablet/pill involved in your case.  You have access to a board-certified toxicologist 24 hours per day to discuss your dilemma and help with recommendations for care.  Since we track occurrence and incidence of poisonings we may have an edge epidemiologically to what is occurring in your area.  We are also available in various venues for provision of educational programs, both "in-person" and electronic.  Lastly, in the face of a significantly symptomatic (or potential for such) toxic exposures, we can immediately provide information (verbal and printed) to help work towards a positive medical outcome.  There are no charges incurred for these services.

Poison center educators provide poison prevention awareness programs throughout our 42 county area.  These programs, geared towards various age groups, provide the foundation for the accidental poisoning preventative efforts and our quest to reduce the incidence of accidental poisonings.  These programs take the form of interactive lectures/symposiums, health fair exhibitions, visits to schools and daycares, and web-based learning tools.  Awareness of the poison center's abilities once a poisoning has occurred can lead to more effective use of health care resources and significant cost savings since the Center can manage over 82% of its residential callers at home without a health care facility visit.

According to Florida statutes relating to the Florida Poison Information Center Network, each of the poison centers in Florida must be located at a health care facility which houses a Level I Trauma center and must also be affiliated with a College of Medicine or Pharmacy.  The Florida Poison Information Center - Jacksonville, is located on the campus of UFHealth Jacksonville Medical Center/University of Florida Health Science Center - Jacksonville and is affiliated with the University of Florida College of Medicine (Department of Health Policy and Epidemiology, and the Department of Emergency Medicine).

Funding for poison centers in the U.S. has included a patchwork of monetary pathways to provide services for which specific institutions cannot bill nor afford to totally underwrite.  The Florida Poison Information Center Network funding system is also complicated.  The Network is principally funded by the State of Florida Department of Health through direct contracts and by matching state for federal dollars (through AHCA) to provide special Medicaid reimbursement funds to our host institutions.  The centers also receive federal grant funds through HRSA to support enhancement efforts and continued growth.  The Centers also share in 50% of the revenue obtained from the sale of the Florida Red Cross license plates.  Finally, each of the 3 centers also receive direct and in kind donations.