R M Mrvos | PubMed Health

PubMed1990

Self-scheduling: a unique staffing approach for a regional poison information center.

For optimal effectiveness, a regional poison information center (RPIC) must be operational 24 h daily, every day of the year. While the formula to calculate the number of full-time equivalents (FTE'S) needed to staff a shift at an RPIC is well known, the best method for successful estimation rotation of an RPIC's professional staff to attain adequate 24-h coverage remains a conundrum. For a 12-mo period, full and part-time Poison Information Specialists at an RPIC self-scheduled all of their work time. Each Specialist rotated 2 shifts (days/nights) or chose a steady off-shift (evenings or nights). On a rotation basis, a Poison Information Specialist schedule coordinator was assigned to "balance" each 4-week period of self-scheduled time. This eliminated inadequate staffing on any given shift. Self-scheduling of work time has impacted positively on staff morale, since it commits the ownership of scheduling to those directly affected by the outcome. Costly illness time has decreased by 23 d/y and administrative staff are able to expand the 10 h, once spent in developing weekly staff schedules, in other areas of productivity.

Humans↗

PubMed1989

Massive caffeine ingestion resulting in death.

Caffeine has long been recognized as an addictive substance with numerous toxic effects. Death due to caffeine overdose is rare, due in part to its marked gastric irritation resulting in spontaneous emesis. Caffeine can be found in food, beverages, analgesics, and over-the-counter weight loss products. We report a fatality resulting from the ingestion of mail order diet pills containing caffeine as their only active ingredient. A 22-year-old female arrived in the emergency department in cardiac arrest after ingesting these diet pills. Resuscitation efforts were unsuccessful. A serum toxicology screen revealed the presence of caffeine with a level of 1,560 micrograms/ml (lethal greater than 100 micrograms/ml). To our knowledge this is the highest reported fatal caffeine level. No other drugs were identified on the screen. Based on the absence of pathology on autopsy and the high caffeine level, death was attributed to acute caffeine toxicity. This case illustrates that deaths resulting from caffeine, although rare, continue to occur.

Adult↗