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The purpose of this Standard Operating Procedure (SOP) is to define the scope, organisational structure, staffing requirements, operational processes, quality assurance mechanisms, and governance framework of the KidsToxLK Poison Information and Research Centre (PIC). This SOP aims to ensure the provision of accurate, evidence-based, timely, and ethical poison information and advisory services to healthcare professionals, caregivers, and the general public, with a primary focus on paediatric poisoning.
All poison experts and specialist contributors associated with the Centre provide their services on an honorary and voluntary basis, without financial remuneration. Their contributions are motivated by professional commitment and a shared interest in improving the quality, safety, and outcomes of poisoning prevention and management in children.
The KidsToxLK Poison Information and Research Centre shall provide round-the-clock poison information and risk assessment services for ONLY children under 14 years of age. The Centre shall offer clinical advice relating to pharmaceutical overdoses, plant and herbal poisonings, pesticide and agrochemical exposures, household and industrial chemical poisonings, as well as envenomation and environmental toxin exposures.
In addition, the centre shall provide guidance on appropriate first aid and pre-hospital care, referral decisions, monitoring strategies, and follow-up recommendations. The PIC shall support emergency departments, primary care settings, and all paediatric in-hospital care settings. It shall also contribute to toxicovigilance, research, education and training initiatives, and public education and poisoning prevention programmes.
The Poison Information and Research Centre shall function under the administrative oversight of the host institution and shall be led by a Medical Director. The organisational structure shall support clinical service delivery, research, education, and quality assurance activities.
Key roles within the Centre shall include the Medical Director, Poison Information Specialists (PIS), a Data and Surveillance Officer where required, an Administrative Officer, and an Advisory Committee as deemed appropriate by the governing body.
Medical Director
The Medical Director shall be a senior clinician with formal training and demonstrable experience in medical toxicology and/or paediatric emergency care. The minimum qualification requirements include an MD in Paediatrics, AND a recognised postgraduate qualification in Medical Toxicology. The Medical Director must have a minimum of five years of relevant clinical experience and demonstrate academic, clinical, or leadership expertise in the field of toxicology.
Poison Information Specialists (PIS)
Poison Information Specialists are responsible for receiving, documenting, assessing, and responding to poisoning-related enquiries received by the Centre. All PIS personnel must meet mandatory qualification requirements and demonstrate competence in clinical toxicology and communication.
Each Poison Information Specialist must possess at least one of the following qualifications in addition to an MBBS degree: an MSc in Medical Toxicology, an MD in Paediatrics, an MD in Emergency Medicine, or a combination of these qualifications. Additional requirements include valid medical registration where applicable, formal training in poison risk assessment, clinical communication skills, and the use of recognised toxicology databases and guidelines. All PIS staff must complete centre-specific induction training and competency assessments and commit to ongoing continuing professional development (CPD).
Training and competency
All Poison Information Specialists shall undergo structured induction training, supervised call handling, and periodic competency assessments. Annual CPD in medical toxicology is shall be necessary, and all training activities and competency evaluations shall be appropriately documented and maintained by the Centre.
All incoming calls shall be answered promptly and professionally. The identity and location of the caller must be established at the beginning of each interaction. Presently, ONLY the calls originating from healthcare professionals will be attended due to limitation of resources and funding.
Each poisoning enquiry shall undergo a structured risk assessment, including documentation of patient demographics, substance or substances involved, estimated dose, route and timing of exposure, current clinical symptoms and vital information where available, and the intent of exposure, including accidental ingestion, therapeutic error, or intentional poisoning. Risk stratification shall be conducted using evidence-based toxicological principles.
Advice and recommendations provided by the Centre shall be evidence-based, clear, non-judgmental, and tailored to the caller’s level of understanding. The PIC shall not prescribe medications. High-risk cases shall be clearly advised to seek urgent referral to an appropriate healthcare facility.
All enquiries must be documented using a standardised data collection system. Records shall include the date and time of the enquiry, the nature of the exposure, advice provided, and outcomes where available. Confidentiality of all data shall be strictly maintained.
Children shall be recognised as a high-risk population in poisoning incidents. Lower thresholds for referral to hospitalised care shall be applied.
Complex, severe, or uncertain poisoning cases shall be escalated to senior Poison Information Specialists or the Medical Director. Formal referral pathways to secondary and tertiary care centres shall be maintained and periodically reviewed.
All services provided by the Centre shall adhere strictly to ethical principles. Confidentiality shall be maintained at all times, and information shall be provided without discrimination. Advice offered by the PIC is advisory in nature and does not replace direct clinical assessment. Mandatory reporting requirements, including those related to child protection, shall be followed in accordance with national legislation.
The Centre shall implement regular quality assurance activities, including audits of call quality, completeness of documentation, and clinical appropriateness of advice provided. Case reviews and morbidity and mortality discussions shall be conducted where applicable. This SOP shall be reviewed periodically, at a minimum of once every three years.
The Poison Information and Research Centre shall participate in toxicovigilance and poisoning surveillance activities, support clinical and public health research, conduct training workshops for healthcare professionals and community stakeholders, and contribute to national poisoning prevention and policy initiatives.
All data generated by the Centre shall be stored securely, with access restricted to authorised personnel only. Use of data for research purposes shall require appropriate ethical approval and adherence to institutional data protection policies.
This SOP shall be reviewed every three to five years and updated in accordance with emerging toxicological evidence, changes in national health policies, and institutional requirements.