Ramathibodi Poison Center’s role as a great pillar in the fight against poisons
As chemicals are everywhere around us, we all can fall prey to many kinds of poison. Globally, poison incidents exceed the number of professionals who can provide proper help. Fortunately, Thailand has “Ramathibodi Poison Center” to tackle this serious problem.
Established in 1996 under the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, the centre started small with only a few staff members who worked 24/7, recounted Prof. Winai Wananukul, Director of Ramathibodi Poison Center.
In its early days, the centre faced and solved several difÄculties, including the high cost of toxicology databases and regional database creation with indigenous venomous animals. One of the biggest challenges was that antidote and antivenom were not often used, were not easily available, and some were expensive; making them sometimes unobtainable at critical times.
The poison centre had been solely funded by the Faculty of Medicine, Ramathibodi Hospital. In 2005, the National Health Security OfÄce
(NHSO) Änancially supported the centre to set up a one-stop-service call centre for the public. Later in 2010, it collaborated with the center to better administer antidotes and antivenoms in a systematic way with the help of external partners, including the Government Pharmaceutical Organization (GPO), Queen Soavabha Memorial Institute (QSMI) and the Food and Drug Administration (FDA). Together, they successfully worked on antidote supply and storage. For example, determining which drugs can be locally produced and which drugs are to be kept near potential patients at provincial hospitals or can be stored at the centre according to epidemiological methods.
Besides effective drug administration, there is an innovative GIS system that locates the nearest antidotes and knowledge sharing sessions on toxicology for doctors, nurses, and pharmacists nationwide. Moreover, the budget for antidote acquisition is reduced while the coverage is expanding. With over 23 years of success and round-the-clock operation,
Ramathibodi Poison Center has proven itself to be one of the most trusted institutes among hospitals around the country and is known for its excellent care of every patient, from step one through to treatment completion.
The centre currently has three full-time and four part-time attending physicians and three medical fellows in Clinical Pharmacology and Toxicology. Plus Äve full-time and 18 parttime scientists who take calls and answer questions on poison. Each year, the centre serves over 25,000 cases. This considerable success has led to Ramathibodi Poison Center being recognised as an international hub that sends antidotes to other countries in cases of emergency.
Prof. Winai spoke of future challenges. The centre needs to figure out how to sustainably manage its operational cost of about 10 million baht each year with no income, he said. Like poison centres around the globe, the centre does not charge patients or physicians for the services. This is to make sure there are no limitations to accessing this services. In the long run, for the public’s good, the centre requires a public subsidy. Moreover, the country needs more toxicology experts and laboratories to ensure quality treatment. The centre aims to empower local hospitals to be able to manage the poisoned patients properly in order to reduce mortality and morbidity.
As one of the eight centres of excellence of Ramathibodi Hospital, Ramathibodi Poison Center believes that the goal of toxicology is to save critical patients before it is too late. Thus the centre is determined to treat patients from all regions of the country regardless of their healthcare coverage schemes, ethnicity, or pre-conditions.