We are the National Capital Poison Center, ready to help you prevent and respond to a poison emergency. AMA!

I just wanted to thank you all. The other night my 4-yo daughter broke a glow-stick and it spurted in her eye. I have never heard her scream like that. And it went on and on...

We called you guys and got a very calm, cool woman on the phone who advised us to stop the saline wash we were trying, get her in the shower and force her eye open for 20 minutes. She told us what to look for and how to act and then called back 20 minutes later, as promised, to check on us.

What's your rule-of-thumb for sending people to the hospital vs. staying home and treating themselves?

You are welcome. Glad we could be of service to you. The decision to send someone to the emergency room instead of treating them at home is based on many different factors including what substance is involved, amount, how long ago the exposure occurred, age, weight, prior medical conditions, symptoms, time of day, distance from the hospital and whether they are responding to home treatments. In general if there is any chance that the person could develop serious injury or life-threatening symptoms they are referred to the emergency room. That being said, poison centers are able safely treat 67% of exposures at home. This is a good reason to call before you go. Many times you will not need to go to the emergency room for common poisoning exposures. Jess Benson, Pharm.D.

What is odorless, tasteless, dissolves instantly in liquid and is among one of the world's more deadly poisons?

Iocane powder, of course. We have all spent the past few years building up an immunity to it. As you wish ;) P Soto, PharmD

If I ever need to call you, how would you prefer that I order the information about the poisoned victim?

Regarding the “order” of the information, the most important initial information to give Poison Control would be: the name/description/brand of the substance that the patient was exposed to (ex: Advil Cold and Sinus liquid, D-Con Bait Pellets, Fabuloso All-Purpose Cleaner, Crayola Markers, holly berries, dog poop, a white mushroom, a brown snake, Tylenol Extra Strength tablets, etc.), how much of the substance was taken (10 tablets, a sip, 2 mouthfuls, one leaf, two pieces, a small taste, etc.), when the exposure/ingestion occurred, how the patient is doing now, what has been done for them so far, and their age/weight.

RP, PharmD, MPH, Certified Specialist in Poison Information

If one finds themselves without access to the internet, is there an easy way to remember what poisonous substances one should induce vomiting for and which ones they should not?

We no longer recommend inducing vomiting for anything. There are a couple reasons why -- 1) we actually found that inducing vomiting does not improve clinical outcomes in poisoned patients; 2) the common emetics people use can often cause more poisoning or injury than the original substance that the person swallowed. Some emetics can cause heart problems, ruptured esophagus, or seizures!

if Poison ever reunites how will you respond?

"Life Goes On", We'll Have "Nothin' But a Good Time"! By the way, if you inhale too much hairspray, call Poison Control. P Soto, PharmD

How do you tell the difference between inhaling too much hairspray vs not enough?

In all honestly, a toxic amount of hairspray has not been established. However, I can say that even a little bit can be irritating to the respiratory tract. Most hairsprays are ethanol, or some other alcohol, and fluorinated hydrocarbons. Fresh air is typically all that is required. P Soto, PharmD

What are some commonly overlooked areas in childproofing? Are there any items that parents don't realize are poisonous?

There are many. Button batteries are some of the most dangerous items that kids get into and they are found in so many products now -- remote controls, toys, hearing aids, key fobs and much more. These batteries can cause life-threatening injuries to the esophagus. Here's some more info: What can happen if a child swallows a button battery?

Also, rare earth magnets -- the really strong ones -- that you can find in kids' toys. If children swallow more than one, or a magnet with a metallic object, they can link up in the gut, trapping tissue between them causing the gut tissue to die.

Finally, I would caution parents and others involved in childcare to not rely too heavily on child resistant caps on medications. These caps are not "child-proof" (nothing is really). Even though they help to slow kids down, many children can open these caps at ages as young as 15 months! N Reid RN/BSN, DABAT

I'm an epidemiologist at a local health department so I have a public health-y question.

In light of the opioid epidemic that we see across the country, is poison control on the national level doing any sort of surveillance to monitor this? What kind of a role does poison control play not only in reporting these instances but also in using the data to study trends and outcomes? If so, what agencies does poison control collaborate with or hope to collaborate with?

Thank you!

Hi. What a great question! Poison control centers collect data and submit these data in real-time to the National Poison Data System (NPDS). These data are used to look at poisoning trends over time and to see spikes in poisonings in near-real time ... opioids included. Right now the American Association of Poison Control Centers (the parent organization for poison centers in the US) collaborates with the FDA and CDC primarily. In addition poison centers collaborate with their health departments, emergency rooms, health systems and sometimes with the Office of Medical Examiner to provide additional data and to enhance mutual surveillance efforts. Realize that dead people don't call poison control and many emergency room physicians will not call a poison center about routine opioid overdose so these collaborations are really quite important if we are going to get a robust view of the opioid epidemic. In addition to surveillance many poison center are involved with drug take back effort and naloxone distribution efforts within their states. Suffice it to say, opioids have been a very important part of poison center activity over the past 10 years.
Jess Benson, Pharm.D.

What is the wildest / Funniest call you guys have gotten?

We've handled over a million calls, so there are SO many that are wild and funny looking back, although at the time we took them quite seriously. Here are a few - and yes they are true:

A "gentleman" called. He had gone out for an afternoon stroll, but was concerned that in his absence the rats might consume his vodka. So he added D-con rat bait to his vodka bottle. His question later....was it still safe for him to consume the vodka.

Here's another one: The chef preparing Thanksgiving dinner for a crowd chopped up daffodil bulbs and added them to the stuffing, mistaking them for onions. The entire batch of stuffing had to be discarded because daffodil bulbs contain a heat-stable alkaloid lycorine. It causes poisoning rapidly - with vomiting, abdominal cramps, shivering and diarrhea. Cases also occurred in livestock in WWII when daffodil bulbs were substituted for scarce feed. Please don't eat the daffodils!

Toby Litovitz, MD

A family called us after attending a funeral where the corpse spontaneously exploded. They were worried that they might explode too. Jess Benson, Pharm.D., DABAT

that's terrifying

Indeed. Not a common occurrence but according to my mortuary colleagues it has happened before. There are no risks of collateral explosions. ;-) Jess Benson, Pharm.D., DABAT

How about the teenager who went to the zoo and stole a gaboon viper snake. He proceeded to put the bag containing the snake over his shoulder while getting on the bus and was bitten on said shoulder.

A child thought that if he ate some batteries that he would have more energy. This is unfortunately not true. Thankfully the battery made it safely into the stomach (as verified by x-ray in the ER), and it passed without issue in a few days. P Soto, Pharm D

How is your budget looking for the next fiscal year?

Don't know whether it's good or bad that we aren't a government agency, but we are not. We're a 501(c)(3) charitable organization. Sadly, the National Capital Poison Center is projecting a budget deficit of $2.2 million - of a total cost of just over $5 million/year. About half of our funding is from state government grants. The rest is philanthropy.

How can we donate?

You can donate here. Thank you!

What are the most common household items people swallow, splash or inhale?

Bleach is definitely a common exposure that people often accidentally swallow, splash and inhale. Although it is not pleasant, it is typically well tolerated, in small amounts. Other than bleach, bathroom cleaners are also pretty common. P Soto, PharmD

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Mr. Yuk, with his green scowly face, was first introduced in 1971 by the Pittsburgh Poison Center and was used in parts of the US. There was some concern that the application of Yuk stickers to products attracted children to the products. In about 2002 there was a move to a single phone number for all 55 U.S. poison centers (1-800-222-1222) and with it a national logo was introduced - Poison Help.

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Times have changed! Poison Help commercial has replaced that one!

That commercial is like on a completely different spectrum from the Mr yuck commercials.

There are even a few different versions, both in English and Spanish, and sheet music too!

So there is a ton of safety information out there for new parents, can you give me some simple tips for not poisoning my kid?

Here's the condensed version.....what we tell everyone to help stay poison safe: 1. Up, up and away! Keep medications and poisonous household products out of your child’s sight and reach. Locked up is best. 2. Avoid container transfer. Some of the most devastating poisonings occur when toxic products are poured into food or beverage containers, then mistaken for food or drink. 3. Read the label and follow the directions. Misusing products has dire consequences. 4. Use child-resistant packaging. It’s not child-proof, but so much better than nothing. Sorry it’s inconvenient, but using it could save a life. 5. Keep button batteries away from children. Swallowed batteries can burn through your child’s esophagus and cause permanent injury or even death. 6. Keep laundry pods out of your child’s reach. They are as toxic as they are colorful and squishy.

Do you think the new pod detergents are helping to prevent little kids from consuming detergent? Or are kids still trying to chow down on the packets?

What do kids mostly eat that causes problems? Is it detergents? Or something else?

It's a little too soon to tell if the new packaging for the pods is helping. Pods are extremely dangerous and they have caused serious injury. When a child puts a pod in his mouth and bites down, the pod pops open and the detergent is forced into the back of their throat. The liquid from the pod goes into the lung and causes injury - some children need to be on ventilators, or breathing machines. Also the irritating liquid can injure the eye as it splashes out of the mouth. Burns are also sometimes seen in the esophagus, again because of the extreme irritation. Regular liquid detergent, while irritating, does not normally cause serious injury in small amounts that children usually swallow.
Common ingestions include household products, such as cleaning products, personal care products like make-up and lotions, and plants. These items are responsible for about half of the calls about kids. The other half include medications, such as cold and cough products and prescription medicine.

Have you ever had someone call in trying to inquire which home substance would make the best poison for criminal intentions?

Yes. Tony Hillerman's son (Tony Hillerman is a famous mystery author) once called to run a few poisons by us. He was helping his dad at the time. I was also asked to give a talk to a group of aspiring authors about qualities of the perfect poison. If you are interested in this topic I recommend a book called "Criminal Poisoning: Investigational Guide for Law Enforcement, Toxicologists, Forensic Scientists, and Attorneys (2nd ed.)" by John Trestrail III. Jess Benson, Pharm.D.

I called because my cat had eaten something, but I pretended that it was my child. Did you know that I was actually calling about my cat?

So we want to stress that it’s always important to be upfront when calling Poison Center since our pets (dogs, cats, etc.) have different metabolisms than humans, and some things that are completely safe for humans can be very toxic to dogs and cats. For example, certain foods that humans can safely enjoy such as: grapes, raisins, onions, shallots, garlic, coffee, and even chocolate can be toxic even in small amounts to our pets!

http://imgur.com/a/tMbLb

RP, PharmD, MPH, Certified Specialist in Poison Information

Do you agree with the Bell Biv DeVoe assertion about that girl?

Yes, that girl is poison. P Soto, PharmD

Follow up: is there any way to mitigate or, I guess, stop a poison from affecting you if there's no known antidote or cure (something that's 100% fatal)?

You can always call Poison Control, but if you are exposed to a very serious substance, you can call 911 and the ambulance will take you to a hospital Emergency Department where expert care will be given. Many poisonous substances don't have an antidote anyway. Patients survive serious poisonings with excellent treatment of symptoms present.

Thanks for the AMA.

Was wondering what sort of exposure would be considered harmful to an average-sized person who happened to break a light bulb containing mercury. Also, what way could the substance enter into the body in that scenario that a person would need to be careful of?

This is a very common question, I'm so glad you asked! Generally speaking, breaking a CFL bulb will not pose much danger to a person. The most important thing is to clean it up and dispose of it properly. The amount of mercury is very very small - it would fit on the head of a pin (much less than what you find in a household thermometer). The mercury vaporizes and so the route of exposure is generally through inhalation. If you break a bulb, DON'T VACUUM it up (this just vaporizes the mercury into the air you are breathing). Call the Poison Center before you do anything else and we will give you step-by-step instructions about how to clean it up and how to minimize your exposure to the mercury. N. Reid, RN/BSN, DABAT

Awesome, thanks. Would you say the description given by the EPA is appropriate or a bit of an over precaution?

Our recommendations are consistent with EPA recommendations. The reason they are so extensive is that out of an abundance of caution, they want to make sure people are not only handling CFL bulbs properly, but also other types of mercury-containing bulbs (large cylinders) properly. Mercury air contamination can be higher with exposures to the larger bulbs.

What has been done to raise awareness of Dihydrogen Monoxide?

Dihydrogen monoxide a.k.a water is necessary for human life. However keep in mind, the poison is in the dose. If someone were to drink excessive amounts of water, it can cause electrolyte disturbances leading to vomiting, seizures, mental confusion, and yes even death. Oh, plus you can drown in it. N. Reid, RN/BSN, DABAT

Besides calling, is there a way people can text or chat poison control?

There are 55 poison centers covering the U.S., each with a designated service area. Some have chat capabilities, but most don't - yet. Throughout the U.S. (or internationally), if you prefer to get your poison help online, you can use the webPOISONCONTROL tool. There you enter age, substance, and amount swallowed and get case-specific automated recommendations, including a determination of whether it's safe to stay home, you need to go to the ER, or you need to call Poison Control. In most cases (73%), it's OK to stay home. We never discourage calls, but if that's not the way you like to get help, feel free to go online. Toby Litovitz, MD

I recently had an experience where someone had ingested kerosene from an unmarked container in the garage, it was mistaken for water. When I called the poison control line, they didn't offer any advice, only asked me questions like, "How do you know that it wasn't windshield wiper fluid?" (It smelled like kerosene and wasn't blue). It also seemed like they were stalling for time. I ended up hanging up and looking up information online instead (don't induce vomiting!).

Was this just an inexperienced operator? Does the phone number get traced in case of an emergency that requires authorities?

I'm sorry that you had an unsatisfactory experience calling Poison Control. I can't really speak to what the specific specialist might have been thinking or what their level of experience might be. In general, Specialists in Poison Information are registered nurses with at least 2 years of experience in the hospital, or pharmacists with a clinical background. Once you are hired by a poison center, you have to train for at least a year, and pass a national exam to become a Certified Specialist in Poison Information.

Our Poison Center utilizes a system similar to 911 to obtain phone numbers and location and we do confirm this information with the caller at the beginning of the call in case the connection drops or the patient becomes incapacitated while on the phone with us. The Poison Centers do have the capability to mobilize EMS to the patient's location if necessary.

And just to be clear, all of this personal information is kept strictly confidential by the Poison Center. N. Reid RN/BSN, DABAT

My friend once stuck a flashlight in his mouth and turned it on to see if it would shine out his eyes. While in his mouth the battery popped and burned the back of his mouth. About 3 or 4 months after (now), he still has the chemical burns in his mouth. Is that a cause for concern?

Yes, persistent, severe symptoms are definitely cause for concern. I would have your friend call his/her physician at this point. He/she needs a medical evaluation and treatment.

What made you want to get into the medical profession?

Most of us were drawn to the medical profession because we had an interest in helping people. I worked at a suicide prevention telephone service while in pharmacy school. Most of the calls were about possible poisonings. During my clinical rotations I saw many poisonings in the emergency room and admitted to the ICU. It seemed like I was drawn to clinical toxicology. Over the years I have seen many changes in poison control. One thing that has remained the same is the poison centers' ability to help people quickly and compassionately. Jess Benson

I had the good fortune of doing one of my 4th year pharmacy rotations at a poison center (not NCPC), and found it one of the most rewarding experiences I've had. Thank you for the great work you guys do!

What is the most obscure/unlikely substance you've encountered in a poisoning case?

It is wonderful to have pharmacy, nursing and medical students on rotation. We all learn from all the questions you ask us. I remember a case where a child came to the emergency room with irritability and progressive drowsiness. He eventually required intubation and mechanical ventilation. Pupils were dilated, dry skin ... the parents had given him a medicine for treatment of diarrhea. One tablet ...Lomotil. He was given naloxone and he stood up and extubated himself. Fortunately we don't see this type of exposure very much anymore. Jess Benson, Pharm.D., DABAT

What's the most common way for people to be exposed to poison?

Ingestion, or eating something is probably the most common, but people can be poisoned through the skin, by inhaling fumes, and eye injuries can occur from chemicals being splashed in the eye. Poisoning can occur from injecting drugs in the vein. The most common poisonings are due to medications found in the home.

Backstory;

So I was on my bed last night getting tired and downs comes the biggest spider in my life a couple feet away from me. My first instinct is oh shit, then I try and look for my Guinness world records book to kill it as it's rappeling down. Long story short, I couldn't find the book and I just stared at it while it made its way down to the side of my bed, where I lost it and still can't find it. I found some Raid bug spray and sprayed it under my bed andon the sides of it. The window was wide open.

Question: How much Raid would be needed to end up in the ER or to be on the phone with you guys?

That is a common scenario. Folks get scared by something and in their panic they use a chemical to try to kill the insect (bees are common as well as spiders). You can certainly try to look it up on webPOISONCONTROL, but if you don't feel comfortable please call us and we'll help you sort it out. You don't have to think you are seriously poisoned to make the phone call. And some people are surprised that many accidental exposures often don't cause serious injury. Sometimes when you are in panic mode it's best to talk to a specialist at poison control, because we are great at calming our callers down.

Do I really need to call poison control if my kid swallows toothpaste? Why can't we come up with a toothpaste that is edible?

Absolutely, it's always prudent to call Poison Control if your child swallows toothpaste (or anything else that he/she wasn't supposed to), but in general small amounts of fluoride-containing toothpastes (ex: less than a mouthful) in children are typically well tolerated. In these cases we usually only see some mild stomach upset or an episode of vomiting. Obviously, larger amounts of toothpaste ingested (especially Rx strength) can be problematic in children. However, there are toothpastes out there that are “safer to swallow”, that do not contain fluoride. They typically contain sorbitol, which may only cause some loose stools.

RP, PharmD, MPH, CSPI

Tell the truth: What do you really think of parents that have to call multiple times a year for the same child that seems to have taste tested half the house?

I think children explore their environments with their mouths. This is totally normal behavior. They are quick and curious and parents are often just one step behind them when things go in the mouth. We don't judge, we want people to call -- even if it is something that seems silly. Call to be sure, don't guess. And if you are too embarrassed to call, use the webPOISONCONTROL app or online tool. N. Reid, RN/BSN, DABAT

What was the hardest part of putting the app together and how do you keep track of the "logic" for all the different possible scenarios?

If you ask the toxicologists (as opposed to the software developers), we'd say the hardest part is developing the algorithms, product database and logic. Each of the 1325+ ingredient algorithms is matched to the corresponding ingredients in 49,000 products - so we have to be able to handle products with multiple ingredients, too. Each algorithm has age- or weight-based thresholds for the ingredient, a list of expected minor symptoms which may develop, a list of symptoms that require further medical evaluation, specific home treatment where appropriate, the expected onset and duration of symptoms and a risk window beyond which significant toxicity is unlikely if symptoms have not already developed. Since algorithms are also used in traditional poison centers, they also outline the justification for the threshold and provide references.

On the other hand, the developers might tell you that the greatest challenge was the overall scope and complexity of the code and the many little nuances required to accommodate variations. Specific logic is incorporated in the software to handle each formulation type, multi-ingredient products, unknown amounts, unknown weight, and the minimum possible weight for age.

It may be difficult to imagine the complexity of the engine driving this app. There are more than 50 administrative interfaces that enable tracking, linking and manipulation of products, images, barcodes (yes, you can scan the barcode of the product your kid swallowed to enter the product name), algorithms, and case data. It also includes tools for quality assurance and data analysis.

Toby Litovitz, MD

what are the most common questions you guys get?

Over half of Poison Control calls are regarding children under 6 years old, with a peak in the 2-3 year old age group. Children this age tend to get into things of convenience - household medications, and cleaners are common. It's amazing how quickly children can get into things. Also, visitors who may have loose pills in their purses or pockets, or pill minders are often accessed and can be a danger. P Soto, PharmD

How do you account for new products that enter the market place? Do they need to disclose the ingredients to you before being allowed to be on a shelf?

Companies introducing new products are not required to disclose their ingredients. Many do voluntarily, which is a big help. But many companies are also fearful their proprietary blend of ingredients will be stolen. In these cases previous experience of the specialist at the poison center can be very helpful in determining likely ingredients and possible concerns.

Are there any items or substances that you would generally recommend people keep on-hand or around the house that may help in an unexpected poison-related emergency?

Yes! Keep handy the telephone number and the url to get help from poison control.

The phone number is: 1-800-222-1222. Or logon to http://www.poison.org and click on the orange “help me with a possible poisoning” button.

No need to memorize any of that contact info. We have a text-to-save vcard functionality. Text “poison” (don’t type the quotes) to 484848 to save that contact info directly to your smartphone. If you know about both of these ways to get help from Poison Control, you are as ready as you can be for an unexpected poisoning!

You can get magnets and stickers with the phone number free from Poison Control from the Poison Center that serves your area.

edit* a typo

Hi NCPC! I read a book on poison response and the vast majority of treatments seem to be ingesting medical grade activated charcoal. In a pinch, if I cut open a water filter filled with activated charcoal and took the same amount, could it be used as a somewhat effective treatment? (This is not an endorsement for people eating Brita filter charcoal instead of going to the hospital, just in a case where you're in the wilderness a few hundred miles away from civilization and just so happen to have a Brita)

Hi! Yes, that is true. People are often worried about getting their stomachs "pumped", but that isn't done very often at all anymore. Activated charcoal is still a method of decontamination that we recommend when an ingestion is recent. You're right - we don't recommend doing home treatments of activated charcoal, because if it is serious enough to require activated charcoal, we will likely want you to go into the ER. Unfortunately, the activated charcoal sold over the counter, and in water filters are probably not as "activated" as the ones available in the emergency room. Also, there are some things that charcoal cannot absorb. Some people get nauseated and vomit after drinking charcoal, which can make some situations much worse (aspiration). Overall, I would not recommend using it. P Soto, PharmD.

What are some common poisons that often get overlooked as safe?

Thanks

In children we worry about imidazoline-containing nasal sprays (contain oxymetazoline or tetrahydrozoline). Most people will not think of them as poisonous because they are over-the-counter and generally viewed as safe. Unfortunately, small amounts can produce loss of consciousness, slowed heart rate and loss of breathing. Button batteries are another example. See our reply at https://www.reddit.com/r/IAmA/comments/5zrfrq/we_are_the_national_capital_poison_center_ready/df0etyz/ We also worry about laundry pods. Jess Benson, Pharm.D., DABAT

Has working in the center/becoming a poisons expert changed any of your habits?

I make sure none of my family or friends ever transfer cleaning products or chemicals in to water/drink bottles. This terrible habit became my pet peeve when someone thought it would be a great idea to put windshield washer fluid in a water bottle. A thirsty worker came into the trailer and drank several gulps and didn't think much about the bad taste because he was busy and had to get back to work. That night he ended up in the intensive care unit in kidney failure. PLEASE stop using water bottles as containers for fluids that are NOT water!

How does one become a toxicologist?

There are a couple different pathways. If you want become a Clinical Toxicologist, you need to become either a pharmacist or registered nurse. Once you have completed school, there is extensive training in care of the poisoned patient, general toxicology and pharmacology, drugs, chemicals, occupational and environmental toxins, biologicals, and toxicology theory. There is a national exam to certify you as a toxicologist if you pass. More information and specifics are available from the American Academy of Clinical Toxicology.

If you want to become a Medical Toxicologist, you have to complete medical school and usually people specialize in Emergency Medicine. Then you can complete a fellowship in toxicology and sit for a national certifying exam. More information is found at the American College of Medical Toxicology. N. Reid, RN/BSN, DABAT

Is alcohol poisoning within your purview? Secondly, if so, what kind of data do you have about alcohol poisoning (and is it made available to the public)?

Yes. You can call or use the webPOISONCONTROL site anytime about possible alcohol poisoning. The previous year's national poisoning experience is published yearly in a medical journal called Clinical Toxicology (http://dx.doi.org/10.1080/15563650.2016.1245421). This report contains statistics for all kinds of poisoning including ethanol (alcohol) poisoning. The report will under-represent the true number of people who suffer from alcohol poisoning because many people will not call their poison center when it happens. It will give you a rough idea however of how frequent these exposures are. For instance in 2015, there were 6761 calls to all U.S. poison control centers regarding possible ethanol beverage exposures. Jess Benson, Pharm.D., DABAT

Vodka + Scope. Do I really need to worry?

Well, the question is a bit vague, but both products contain ethanol in different percentages. Vodka is typically around 80 proof or 40% ethanol, and most over-the-counter mouthwashes can vary from 5-20% ethanol depending on type and brand. Rinsing and spitting with mouthwash after a night out drinking vodka isn't going to be a problem, but someone drinking Scope (or any other mouthwash) because they ran out of vodka is most certainly a cause for concern and Poison Control should be called immediately. That said, sometimes children will accidentally swallow a mouthful of mouthwash, which typically only causes some mild stomach upset or an episode of vomiting - but always remember to call Poison Control regardless!

RP, PharmD, MPH, CSPI

Hi NCPC! What does the development effort look like for something like this?

Hmmm.....there are 3 ways to read this question. I'll take a stab at them since I don't know which you are asking: Version 1: Development = fund raising. My answer is "ouch". It's really hard to keep both a poison center hotline and webPOISONCONTROL funded. Feel free to donate to support us!

Version 2: Development = compiling the information for webPOISONCONTROL. That takes a team of 4 toxicologists and several Specialists in Poison Information to draft algorithms (now more than 1325 of those) and develop and maintain a product database with 49,000 products.

Version 3: Development = software development. That's an impressive task. We're now working on version 3 with a team of 12 software developers, analysts and testers. It's a project requiring constant expansion and redevelopment, always in response to public demand and feedback. At present, we're adding eye, skin, inhalation and bite/sting routes to the app that currently focuses on swallowed poisons. Toby Litovitz, MD

I'm not sure if it's been asked already, but did Poison Control have anything to do with Nintendo adding a bitter agent to the new Switch game cartridges?

Poison Control did not recommend bittering agents. This is an often-proposed "solution" for anything that might be swallowed, but there are several scientific papers demonstrating that bittering agents don't work to prevent poisonings. It's a theoretically good idea which never panned out in practice.

Have you guys ever rescued someone from swallowing to much toothpaste?

There actually have been some serious cases where children have swallowed too much fluoride toothpaste. Fluoride reacts with the stomach acid to produce hydrofluoric acid, which typically causes vomiting when too much is ingested. Additionally, the extra fluoride binds to calcium so tightly that it actually pulls it out of the blood circulation. Our muscles need calcium to work properly and the heart is a muscle. A person can have serious heart dysrhythmias with low calcium. I can think of a recent case where a child was referred to the emergency room and needed immediate correction of his calcium level. His dysrhythmia improved and he went home happy. P Soto, PharmD

I just listened to Bell Biv Devoe's hit 1990 single "Poison" 10 times in a row, should i be worried that a poisoning occured and should i call you?

I think you should be okay to watch this one at home. P Soto, PharmD

Which poison can paralyze your body or make you numb within seconds and how can you avoid it or treat it?

There are many substances that can cause numbness and paralysis within seconds, however, most are not available to the public. One of the more famous "natural" substances is curare, a poison derived from a South American plant. It was used in blow gun darts. Today we have a number of VERY potent drugs that are used to produce paralysis before putting patients on a ventilator (e.g succinylcholine). Fortunately, it would be very unlikely that you would be exposed to this substance since it is only available to doctors, nurses and pharmacists in hospitals. Jess Benson, Pharm.D., DABAT

I accidentally swallowed some apple seeds today should I smoke a cigarette to suffocate the bacteria in my stomach?

Honestly, that's not a recommended course of action given that 1) the majority of bacteria in your stomach (and primarily in your intestines) are not harmful and often necessary for vitamin absorption and breakdown of certain foods, 2) enteric bacteria don't require oxygen to survive and most species don't smoke, 3) smoking even a single cigarette is significantly more toxic than swallowing a few apple seeds. In closing, remember it’s always prudent to call Poison Center if you suspect that more than just a few apple seeds may have been ingested.

RP, PharmD, MPH, CSPI

Once I accidentally took one of my dog's heart med pills. (Mixed up bottles.)

I called poison control and was basically told I was on my own because they didn't have a clue.

What if a child had taken one? Is poison control still not going to have a clue? Just go to ER? Would they know what to do without calling?

This is a very serious call. Of course, I don't know who you spoke with, or which poison center you may have reached, but we would manage this case by obtaining detailed information about your symptoms, the drug ingested, and the time-frame. If we did not have enough information about a drug because it is not used in humans, we would facilitate your transport to the hospital by EMS. We would never tell you you are on your own.

Is poisoning via animals (like snakes, spiders or scorpions) really common?

In the Washington DC area, we do not have any scorpions, but our colleagues in other regions get calls on them all of the time. We do have spiders and snakes however, and we get calls on them almost year round (snakes take a break during the coldest months). Some days during the Spring and Summer, we get 2-3 snake calls per day! It depends on the weather. P Soto, PharmD.

You mean Trump hasn't defunded you yet? I'd make sure your LinkedIn profiles are current...

We're not a government agency! But we do get a bit of Federal funding through a grant - about 9 cents of each dollar we spend to provide service. We depend on donations from individuals to keep the Center open and close our $2.2 million annual funding deficit.