October 8, 2020

Q&A with a veteran call responder at the Michigan Poison Center at Wayne State University

Perri Kern, R.N., has served as a certified Poison Specialist with the Michigan Poison Center for 30 years.

Perri Kern, R.N., is a Certified Specialist in Poison Information with the Michigan Poison Center (MiPC) at the Wayne State University School of Medicine. She spent three years as a pediatric Emergency Department registered nurse before taking on her role as a poison specialist with the MiPC managing poisoning emergencies and fielding calls from homes, health care facilities, and various government and law enforcement entities.

Question: How long have you been with the Michigan Poison Center as a Poison Specialist?

Answer: I’ve been in the Poison Center for 30 years. And I’ve been a nurse for 33 years. I’ve seen the Poison Center transition through the years, as well as the trends.

Q: How does a typical day for you begin?

A: Our day revolves around the 24-hour emergency hotline service – 1-800-222-1222. We’re all either nurses, pharmacists, or physicians. The specialists who staff the hotline phones are very well-educated. Our training process is very extensive. Our day revolves around handling all incoming calls as well as placing outgoing calls to health care facilities and homes for follow up. We don’t have the direct patient contact by hands and visual, but we are part of the treatment team for the purposes of outcome, diagnostics, and whatever the clinical treating team needs us to help with from the toxicology perspective.

Q: What interests you about your job? Why keep doing it for 30 years?

A: Being a nurse, you sometimes get to the point where you burn out on something and I just haven’t done that here because it’s ever-changing. The calls we receive are something new all the time. You never know what the next call will be. So, it goes along with my Emergency Department experience. You never know what’s coming through the door of an Emergency Department. It’s the same thing here. You can have something very simple one second and the next step can be fighting for somebody’s life. I think it challenges me. With the emerging trends that occur in toxicology, whether it’s nationwide, statewide, or local to the greater Detroit area, there’s always something new coming out. And I like helping the people, whether it’s from the hospital or a home call, I like just helping these people to get through their moment of crisis.

Q: What are some trends you’ve seen in the last year?

A: One of the big trends that hit us just about a year ago was the vaping issue, with people vaping liquid nicotine and cannabis. We were involved with a young man who ended up having a double-lung transplant because of the injury to his lungs from vaping. He was a minor. So, it was quite a traumatic experience. It’s traumatic for anybody. People have died from vaping and the injuries it causes to the lungs. Since then, he has recovered and has done well, but it’s things like that that can come out of the blue by one habit-forming situation or trend that starts developing amongst a population. After it’s been out there for a short period of time, you see the devastation it can cause to the human body. Cases like this pull in a lot of individuals from a variety of backgrounds and expertise to investigate and figure out how we can help these people and prevent future occurrences.

Q: What is your most common call topic?

A: In the household setting, it’s kids getting into some form of a household product. Tide Pods® are very attractive. They seem to be popular. But cleaning agents in general, something they can get out of the bottom of the cabinet or the cabinets they can reach, like underneath the sinks, are very common with kids. Also, adult medications that aren’t properly stored, or if they’re in the presence of elderly caretakers or older-generation caretakers in homes that are not ‘poison-proofed.’ This becomes an issue with medication accessibility.

Q: Can you tell me more about your role working with hospitals and health care providers?

A: Physicians, typically residents, sometimes the nurse, will call to find out what to do for a patient with a potential toxic exposure. With our background and our experience, we are treating that patient remotely. The treating clinical team is telling us what they’ve got in front of them and we are telling them what we think of the case and how to manage the patient. It’s just like being in the Emergency Department with a patient, and you’re responsible for the toxicologic patient management perspective.

Q: What is the certification process to become a call responder at the Michigan Poison Center?

A: After you've been here for two years or a year and you've handled a certain amount of calls, you’re required to sit for the National Specialist in Poison Information Examination. If you pass the exam, then you are required to recertify every seven years, and this ensures maintenance of your critical skills in the toxicology discipline. You have to be certified to work here once you qualify. Most people think we’re volunteers handling people calling in from home, and they don’t understand the complexity of what we really do. We perform drug identification confirmations for the police force, Drug Enforcement Administration, and border patrol. We’re heavily involved right now with the increase in hand sanitizer exposures with the U.S. Food and Drug Administration that are being recalled because of these products being contaminated with methanol, a very dangerous toxic alcohol. Our Medical Director revamped our policy and procedure on what we’re doing with hand sanitizer exposures right now strictly because of this risk. There have been deaths across the nation from people drinking hand sanitizer contaminated with methanol.

Q: How many calls do you handle an average shift?

A: Individually, it’s not uncommon to receive anywhere between 20 and 40 calls per shift. Collectively as a group, we’re well over probably 250-plus calls per day, pushing 300 calls most of the time. We cover the entire state of Michigan, and we get calls from other states, Canada, and overseas, including stationed military.

Q: What is one of your more recent interesting cases?

A: We received a call regarding an individual who was bitten by a snake in the Upper Peninsula about a month ago, during our snake season here in Michigan, but this was an exotic snake. He was a physician, he was in the UP and we had to mobilize him from an outlying area of the UP to the treating hospital. From there, he had to be transferred to the lower part of Michigan because the facilities out there did not have the antidote he needed. We were the ones who helped identify the facilities who had the antidote because we had done a study on what our supply chain consisted of around the state of Michigan. We know where our antidotes are, so we were the ones to instruct the hospital on getting him to the right facility, because time is of the essence in a snakebite.

Q: What is the biggest misconception people have about the Michigan Poison Center?

A: That we report them to the police, or to Child Protective Services. We don’t get involved in that. There are exemptions to that if we feel that a child is in danger and needs to get help and the adult is not able to do that, but in general, the average layperson thinks that every case we get we report to the authorities. That’s not what we're about. We’re here to help them. We don’t want them to fear calling us because we’re in fact their lifeline, and we can help them and provide valuable resources in their time of need.

The Michigan Poison Center at Wayne State University is a statewide 24-hour, 365-day free resource for poison help, information and education. Call 1-800-222-2222 for help or visit mipoisonhelp.org for more information.

The interview has been edited for clarity.