1. A partnership for adverse reaction reporting Marsha Ford, MD - Director, Carolinas Poison Center Amanda Fuller, PharmD – NC SNS Coordinator

2. The Initial Question After a mass dispensing campaign begins, how are the adverse events monitored, collected and recorded?

3. The Needs A way to take numerous calls A consistent way to collect data A method to transmit data to the state in a timely fashion A method to report to FDA any ADRs reported when required A single reporting system for medication and vaccination adverse events

4. The Plan CPC is a part of the NC PHPR call down Notification can go from PHPR to CPC or CPC to PHPR CPC will call in additional staff as needed Local Health Depts will route medication related questions to direct CPC number

5. CPC notified SNS meds to be dispensed meds to be dispensed CPC staff activated activated AHEC faculty notified notified PY4s contacted & report to CPC & report to CPC Training @ CPC PY4s answer calls at CPC calls at CPC Crisis resolving; call volume call volume PY4sdeactivated Normal CPC staffing resumed

6. September 24, 2007 Carolinas Poison Center Program Highlights and Surveillance Activities

7. Carolinas Poison Center: Operations NC-designated PC Staffed 24/7/365 RNs/Pharmacists Toxicologists: 3 MD & 1 PharmD Administrative & support staff AAPCC-certified Utilize national toll-free number, 800-222-1222

8. Carolinas Poison Center: Operations Data Collected & entered by Specialists as part of case management Electronically maintained with frequent backup Case data uploaded every 6-10 minutes to the National Poison Data System - NPDS (formerly TESS) Case data uploaded every hour to NC DETECT Pesticide case data uploaded every 24 hours to NC DPH Occupational Epidemiology Resources Computerized information databases Books, guidelines, internet Public Health: preparedness & epidemiology EMS: Dispatch and All Hazards personnel Calls digitally recorded

9. CPC - Scope of Services Exposure Calls – Triage, diagnose, provide expert advice Pharmaceuticals Drugs of abuse Household products Chemicals Plants, Bites/stings Food-borne illnesses Information Calls Public Health – collaborate with NC DHHS Occupational pesticide exposures Surveillance & investigation of All-Hazards incidents Education & Prevention: Professional & Public Research

10. CPC - Key Operational Metrics: Call Volume

11. CPC Surge Capacity: O ffsite Work Configuration Cisco router CPU Data Center Service provider Specialist Carolinas Healthcare System VPN/Cable BellSouth VPN Or Cable w/ Forsythe Juniper Box VPN/Cable Nortel soft phone CPC

12. Utilize software to track specialist In-Call status, log-in and log-out Communicate rapidly with off-site specialists via Instant Messaging

13. CPC - Surge Capacity Response Twenty-two off-site workplaces exist System is used daily Must be maintained and upgraded In event of surge Current staff will work off-site Pharmacy students will work in the poison center, supervised, to answer questions from public

14. CPC – Public Health Surge Response Guidelines and Q&A sheets To handle anticipated pandemic & all-hazards events Cross-train alternative providers to answer questions from public during outbreaks Utilize guidelines and Q&A sheets Just-in-time training Data uploaded to DPH every hour Real-time communication between CPC toxicologists and DPH