Podcasts Business Pharmacist's Voice Interview with Dr. Wendy Stephan, educator and epidemiologist for the Florida Poison Information Center in Miami

Interview with Dr. Wendy Stephan, educator and epidemiologist for the Florida Poison Information Center in Miami

Published: July 17, 2020, 4:30 a.m.

Today\u2019s episode is an interview with Dr. Wendy Stephan, an educator and epidemiologist for the Florida Poison Information Center in Miami.\xa0 As a poison prevention advocate and educator, she shares important messages through storytelling.\xa0 **Listener discretion is advised.**\xa0 Some of the topics in this episode include children putting weird things in their mouths, poisoning, injury, death, medicine looks like candy, and more.\xa0 Again, listener discretion is advised.

Dr. Wendy Stephan is the educator and epidemiologist for the Florida Poison Information Center in Miami.\xa0 For the past 12 years, Wendy has promoted the use of poison control and worked to prevent poisonings of all kinds, including from medication, household chemicals, and environmental hazards.\xa0 Wendy completed her PhD in Epidemiology and her Master of Public Health degree at the University of Miami and has previously chaired the Public Education Committee of the American Association of Poison Control Centers. \xa0

Website, e-mail, and social media links

\u2022 Website(s): www.floridapoisoncontrol.org

\u2022 Email: wstephan@med.miami.edu

\u2022 LinkedIn: https://www.linkedin.com/in/wendy-stephan-phd-mph-315b70178/

\u2022 Twitter: @floridapoison


Mentioned in the episode

Highlights\xa0

The Florida Poison Information Center in Miami partners with two other centers to serve the state of FL:\xa0 Jacksonville and Tampa.\xa0 The Miami location serves South Florida.\xa0 The Jacksonville location also serves the US Virgin Islands. \xa0

There are 55 poison control centers in the US.\xa0 Every state and territory has access to one.\xa0 Calls are geographically routed to a call center.\xa0 One poison center may serve multiple states.

Contact your local poison center for prevention education.

As a poisoning prevention advocate and educator, Dr. Wendy Stephan shares important messages through storytelling.\xa0 People in crisis have stories, which connect with people better than cold facts.\xa0 We are programmed as humans to learn through stories.

She teaches pharmacy students.\xa0 Students enjoy interacting with the community.

March is Poison Prevention Month.\xa0 The 3rd week of March each year is Poison Prevention Week. \xa0

The poison help line number is 1-800-222-1222.\xa0 Program it in your phone.

Sometimes, law enforcement needs pills identified.\xa0 The poison help line is a great resource for pill identification because calls are recorded and can be used later (by subpoena) if needed.

Teaching kids \u201casking behavior\u201d is important.\xa0 \u201cMom and Dad, what about poison control?\u201d

Wendy\u2019s work impacts all ages.\xa0 According to Wendy, working with caregivers and teachers is more helpful than working with toddlers because it touches more lives and avoids toddlers misinterpreting messages [about poisons].\xa0 \xa0

Older adults and DD caregivers need Poison Control too.\xa0 For example, older individuals with poor vision who may be reading bottles in low light and have multiple medications are at risk for medication errors.\xa0

Organizations like Elder Affairs or an Area Office on Aging is a great place for pharmacists and pharmacy students to volunteer to speak about poison prevention.\xa0 Be careful:\xa0 don\u2019t lecture, don\u2019t stigmatize.\xa0 They know they\u2019re taking a lot of medications. \xa0

Wendy realized she had a passion for poisoning prevention at the age of 6, when she saw a \u201cMr. Yuck sticker.\u201d\xa0 As an adult, she started in poison prevention while working as an educator with Lora Fleming, a Marine Scientist.\xa0

Working at the FL poison center is like the Super Bowl for an epidemiologist.\xa0 It\u2019s a once-in-a lifetime experience to be working in the field. \xa0

The COVID pandemic has affected injury epidemiology in FL:

  • Hand sanitizer exposures (eyes, mouth) have increased compared to this time last year.
  • Disinfectant exposures have increased.
  • Bleach exposures have increased.
  • [As a class,] household cleaning product exposures have increased.
  • FL Poison Information Centers have helped the FL Dept of Health with their COVID-19 hotline.\xa0 Training and resources were provided quickly.\xa0 There have been >50,000 calls to the FL COVID-19 hotline so far.
  • FL Poison Information Centers have seen an increase in calls about supplements and vitamins.\xa0 Ex:\xa0 vitamin C, vitamins in general, dietary supplements, and homeopathic remedies

Pharmacists need to be aware that people are self-treating with OTC\u2019s.\xa0 While patients are at the counter for counseling, ask if they\u2019re taking anything or \u201cmega dosing.\u201d\xa0 Supplements can interfere with medications. \xa0

Who are Dr. Wendy Stephan\u2019s coworkers?\xa0 Doctors, nurses, and pharmacists who are certified specialists in poison information (abbreviated C-SPI or SPI).\xa0 Her staff are 100% physicians in Miami.

Wendy provides support to her coworkers and trains safety educators in the community.\xa0 Ex:\xa0 healthy start program home visitors who work with parents.\xa0 Ex:\xa0 foster parents and medical foster parents.\xa0 By reaching home visitors (people who work with parents), she reaches more parents.\xa0 It\u2019s efficient.

Works with other poison educators and colleagues around the state to design materials:\xa0 fliers, social media messages, etc.\xa0 Content relevant to the news gets good engagement.\xa0 It\u2019s hard to get attention when you\u2019re competing with other content.

Two things that Florida has that Ohio does not have are snakes and aquatic toxins.\xa0 People fear snakes, but there are only ~6 bites per month from venomous snakes in FL.\xa0 Images of captured snakes in a bucket are something the FL Poison Information Center sees often.\xa0 Sometimes the Emergency Dept calls the Poison Information Center for support.

Ciguatera Fish Poisoning happens in Florida.\xa0 This marine toxin can even reach Ohio when fish are transported.\xa0 Jelly Fish stings from the Portuguese man o\u2019 war and the Box Jelly Fish are common too.\xa0 Marine toxins change over time, and some toxins can cause someone go into shock.

Who do I call?\xa0 9-1-1 or Poison Control?

Call 9-1-1 if someone is unconscious, having trouble breathing, having chest pain, there lots of bleeding, or there has been an intentional poisoning.\xa0 EMT\u2019s will call the poison information center when needed. \xa0

Most 1-800-222-1222 poisoning calls usually present as\xa0

  1. Someone swallowed something unusual
  2. Someone made a medication mistake.\xa0 At first, they seem fine, and there is no drama.\xa0 Even when symptoms are not immediate and dramatic, call for help!\xa0 Poison Control can walk people through symptoms that may develop.\xa0 Then, Poison Control makes follow-up telephone calls.\xa0 Ex:\xa0 toothpaste + milk = vomit that looks like cottage cheese, and that\u2019s a good thing.

Iron poisonings are serious and deadly because of multi-organ involvement.\xa0 Iron tablets can be attractive to children and may look like candy.\xa0

According to Wendy, child-resistant packaging slows a child down ~ 30 seconds.\xa0 Child-resistant packages do not guarantee safety.\xa0 Lock boxes help prevent medication-related poisonings in all ages.\xa0 Make it a habit to hide medications in a lock box.\xa0 20% of poisoning deaths are intentional due to depression or a moment of panic.\xa0 Lock boxes could slow someone down long enough for the self-harm impulse to pass.

Prevention is for all ages.\xa0 Best practices:

  • Don\u2019t stockpile medications.\xa0 (Ex:\xa0 Hurricanes and emergency preparedness)
  • Medications that are older and expired may cause confusion about who they\u2019re for, or why they\u2019re on-hand.\xa0 If you have forgotten it\u2019s even in the home, it\u2019s time to get rid of it.
  • Drug disposal is important.\xa0 Use drug disposal programs and do routine \u201csweeps\u201d and get rid of anything you don\u2019t need.\xa0 Don\u2019t accumulate dangerous and unnecessary meds in the home.\xa0
  • Some drugs are like time bombs in the home.\xa0 Ex:\xa0 Hydrocodone and teens or someone depressed due to loss of job.\xa0 Get rid of it!\xa0 It\u2019s dangerous to keep around.\xa0
  • DEA Take Back Days are an option twice/year.
  • Some communities pair drug take-back with \u201cshred days\u201d to prevent poisonings and identity theft as a 2-for-1 service.

The National Poison Data System provides nearly real-time poison center data.\xa0 This information is reported to the Health Dept and the CDC. \xa0

  • Contaminated products
  • Street drugs
  • Confusing packaging on consumer products.\xa0

Placing a case report helps the poison center identify problems and respond or get the attention of someone who can respond/initiate a public health response.\xa0 Ex:\xa0 e-cigarettes.

Is it better to call Poison Control or use a poison information website?\xa0 Poison information websites are available, but calls are better because diagnostic information can be collected by phone.\xa0 Ex:\xa0 slurred speech (impairment is present).\xa0 Ex:\xa0 hearing someone cough after a baby powder exposure.\xa0 If someone is hearing impaired, the websites can be a helpful alternative.

A typical week for Wendy involves a mix of office and community work.\xa0 Building relationships is important.\xa0 She likes the variety and challenge.

Wendy uses a visual aid with high school students, emergency room doctors, and others called the \u201cCookie Jar of Doom.\u201d\xa0 It contains pictures or items to represent the 12 most deadly poisons in Florida.\xa0 It leads to great discussions.\xa0 Examples include:

  • Carbon Monoxide
  • Prescription drugs:\xa0 oxycodone, hydrocodone, methadone
  • Illicit drugs/street drugs:\xa0 cocaine and heroin
  • Benzodiazepines\xa0
  • No snakes, no spiders.\xa0 Nothing is alive in the jar.\xa0

The source of the items is data from the Injury Prevention Program at the FL Dept of Health on substances leading to deaths.\xa0 For more information, see the \u201cpoisoning data\u201d tab on the Florida Poison Information Center website.

Stories, games, and interacting with things physically are universally fun for everyone, and variety is good.

What is the scariest poison?\xa0 Alcohol.

  • Alcohol changes behavior and judgement, unlike many other poisons.
  • Very serious cause of injury death
  • Alcohol poisoning can result.
  • Alcohol can lead to car crashes.
  • Alcohol can lead to a fatal interaction with a weapon.
  • Alcohol can lead to self harm.
  • It\u2019s the most stealth poison.
  • Alcohol has been partly responsibility for 25% of deaths one year in FL.\xa0 It flies under the radar.\xa0 Children can\u2019t metabolize alcohol, so they can easily become injured. \xa0

How (in general) can someone prevent a poisoning?

  • Awareness of different poison hazards in the home.
  • Prevent medication mistakes
  • Prevent product exposures
  • Look at the labels
  • Store medications up and away above shoulder height in a cabinet with a closed door. \xa0
  • Drawers and shelves are not good places to store medication and household products. \xa0
  • Know what to do if something happens.\xa0 Call Poison Control.\xa0 Have the number handy.\xa0 Don\u2019t \u201cwait and see\u201d when there has been a medication error.\xa0 Call right away.
  • Knowing about \u201cpretty poisons\u201d and look-alike items is helpful.

What does Dr. Wendy Stephan love most about working for the FL poison information center?\xa0 Great colleagues in FL and across all poison information centers and being in the community.

What is a challenge she faces?\xa0 Getting the word out about their center and getting people\u2019s attention.\xa0 People think, \u201cit won\u2019t happen to me.\u201d \xa0

Calls to Poison Control are confidential.\xa0 There is HIPPA protection.\xa0 Poison Control fields plenty of calls from individuals suffering from mental illness.\xa0 Poison control centers don\u2019t judge.\xa0 They don\u2019t call child protective services either.\xa0 Some communities are fearful of children being removed from the home (suspected abuse). \xa0

Epidemiologists use data to understand the big picture.\xa0 Epidemiology drives effective interventions.\xa0 Injury data is important.\xa0 Talking about medication safety and alcohol will save lives.\xa0 Local, state, and national data drives effective interventions and actions public health epidemiologists make. \xa0

How can pharmacists help?\xa0 Be that trust professional who can educate people, share expertise, etc. because you have relationships with patients and key members of the community. \xa0

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