Listener discretion is advised. Some of the topics in this episode include children putting weird things in their mouths and poisonings.
Today’s episode is an interview with Angel Bivens. Angel is a pharmacist by training. She has experience in retail, hospital, home infusion, and mail order pharmacy, but her true passion is working at the Maryland Poison Center (MPC). The Maryland Poison Center is part of the Department of Pharmacy Practice and Science at the University of Maryland School of Pharmacy.
Angel has been with the Maryland Poison Center for over 25 years. She spent the first 8 years as a specialist in poison information managing poisoning and overdose cases from the public and healthcare professionals. Then, She spent the next 17 years in the role of public education coordinator, ensuring the more than 4 million Marylanders in the MPC service area know about their services and learn ways to keep their families safe from poison dangers in an around their home. Now an assistant director, Angel oversees operations and public education. When she started this role in 2018, she combined her love for educating the public with responsibilities that ensure there is always someone there to help with a poisoning or overdose 24/7/365.
Angel completed her BS in Pharmacy at Duquesne University (Pittsburgh PA) and her MBA at University of Baltimore (Baltimore MD). She also holds the designation of Certified Specialist in Poison Information (CSPI) after successfully completing the American Association of Poison Control Centers certification examination in 1990, 1998, 2005, 2012, and 2019.
For more information
Angel LinkedIn: angelbivens
Maryland Poison Center website: www.mdpoison.com
To find your local poison center: www.aapcc.org
Resources for pharmacists and their patients:
Poison Prevention Press: http://bit.ly/PoisonPrevPress
One-page, plain language e-newsletter published every other month on varying topics; all current and previous issues available
Poison Prevention Press sign up: http://bit.ly/MPCSignUp
eAntidote Blog: blog.mdpoison.com
Facebook: MarylandPoisonCenter
Twitter: @MDPoisonCtr
YouTube: Maryland Poison Center
Resources with clinical information for pharmacists:
ToxTidbits: http://bit.ly/ToxTidbits
One-page clinical e-newsletter published monthly on various toxicologic topics; all current and previous issues available
ToxTidbits sign up: http://bit.ly/TTBSignUp
Twitter: @MPCToxtidbits
Highlights from the interview
Angel wore many hats over her years at the Maryland Poison Center. As a Poison Center Specialist, she managed poisonings and overdoses. As a Poison Center Educator, she educated the public and created educational materials. As an Assistant Director, she improves the visability of the poison center and forms partnerships in the community.
As a pharmacy student, Angel loved toxicology. As a young pharmacist, she heard about an opening at the MPC, applied, and got the job right away.
Pharmacists, nurses, and doctors staff most poison centers. Poison Center job applicants need to match the Center’s needs. In general, a PharmD with experience is required for pharmacist applicants. No additional residency or certification is needed.
Once hired, on-the-job training is extensive. It can take at least 3 months before a pharmacist is ready to manage cases independently after training. After managing 2,500 human exposure calls, pharmacists are required to sit for the CSPI Exam to become a Certified Specialist in Poison Information.
What resources do poison specialists use most often? Angel said, the poison center staff’s experience and knowledge base is a great resource! Because they manage 2,000-5,500 calls/year, they learn a lot. Over many years, that knowledge base is big! Other resources include Poisondex, Gold-Franks Toxicologic Emergencies, Lange: Poisonings and Overdoses, online journals, and consultants (medical and clinical toxicologists).
Angel told a memorable story about a call she answered from a teenager who OD’ed on aspirin. Back in the day, the poison center traced the call and called an ambulance. The patient got treatment and survived.
The best way for anyone to contact the poison center is 1-800-222-1222. It’s a “smart phone number” and directs you to the nearest poison center geographically. Poison Centers work together, so cases are seamlessly transferred to local poison centers assigned to your area. It even works on US cell phones outside the US. Calls are triaged, but all are managed.
There’s no such thing as the “busiest day of the year,” but on July 4 and Halloween, there are lots of calls related to glow sticks.
Poison centers field calls from a variety of callers: fire, EMS, parents of kids of all ages, children of elderly parents, grandparents raising grandchildren, Emergency Centers, critical care teams, pharmacists, and more. Reasons pharmacists call poison centers: Drug ID, drug-drug interactions, drug-supplement interactions, and non-medicine ingestions.
Angel says that knowing you’re actually helping someone is a great feeling. It’s very rewarding.
Angel knew it was time to change hats from poison specialist to educator when her young son wanted her to be home when he was home. Becoming an educator helped her have a more consistent schedule, mostly M-F on day shift. She used her marketing and communication skills as an educator. Plus, her MBA qualified her for the role.
Angel educates pharmacy students, medical students, paramedics, and more. MPC has a robust educational program, so she can sit in and listen to the toxicologist talk about cases.
The most unusual call Angel fielded was about a goat who ate something the owner thought the goat should not have eaten. Her database has some information about animals, but Poison Centers focus on humans. Angel gave the goat owner two phone numbers for animal poison centers, and the goat’s owner was happy to try those. I mentioned that this story reminded me of the children’s book Gregory the Terrible Eater.
One of the biggest challenges poison specialists face is managing oddball cases. New things don’t have a lot of literature to research. Sometimes, poison specialists need to consult with clinical toxicologists for oddball calls. Plus, the phones keep ringing while trying to manage oddball cases; that’s a challenge too. As an educator, a challenge is reaching people. As an Assistant Director, a challenge is getting the phones staffed. It’s also a challenge to get people to call vs using Google. Angel urges everyone to get the right answer right away from a trained poison specialist. Call a Poison Center 1-800-222-1222. Taking the time to look at Google and sort through search results might be misleading and delay treatment. Poison Centers make follow-up calls for exposures.
Poisonings can happen to anyone. Parents who work at poison centers have also had to call. It can happen to anybody.
Angel said that the best things about working at the poison center are helping people and the variety of exposure cases. Poison specialists don’t get bored. She likes to learn about new drugs, chemicals, TikTok videos, and things on the news, like “challenges.”
One thing people don’t realize about working at a poison center is that pharmacists, nurses, and others answer calls and respond without a script.
Over the years, Angel has worked different schedules. As a poison specialist, it varied. Present day, shifts on weekdays are 12 hours in length; weekend shifts are 10-hour shifts. Midnight-shift pharmacists work 7-on/7-off. Poison Specialists work holidays too. As an educator, she worked mostly days, but she worked some evenings and weekends for programs too. As an Assistant Director, Angel works typical administration hours.
Poison Prevention Week is March 21-27, 2021, to raise awareness about poisonings. According to the AAPCC’s website, the third full week in March each year is National Poison Prevention Week (NPPW), a week dedicated to raising awareness to poison control centers and the Poison Help Hotline (1-800-222-1222).
How can pharmacists get involved? Visit aapcc.org or reach out to your local poison center and ask to speak to the educator. Call 1-800-222-1222 to get in touch with the educator at the poison center. Pharmacists can set up a table with resources. Some poison centers are looking for volunteers. Ask educator how you can get materials: stickers, magnets, and brochures.
