National Poisons Information Service

A service commissioned by Public Health England

 

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Members of the public

seeking specific

information on poisons

should contact:

 

In England and Wales:

NHS 111 - dial 111

 

In Scotland:

NHS 24 - dial 111

 

In N Ireland:

Contact your local GP or

pharmacist during

normal hours; click here

(www.gpoutofhours

.hscni.net/) for GP

services Out-of-Hours.

 

In Republic of Ireland:

01 809 2166

 

Healthcare

professionals seeking

poisons information

should consult:

www.toxbase.org

TOXBASE

Please note that if the TOXBASE website is not working please try the backup site: www.toxbasebackup.org

 

TOXBASE is the primary clinical toxicology database of the NPIS. It is the backbone of the service and the first-line resource for UK healthcare professionals.

 

The TOXBASE database provides information about routine diagnosis, treatment and management of patients suffering from exposure to a wide range of pharmaceuticals, chemicals (agricultural, household and industrial), plants and animals.  The database includes information on approximately 17,000 entries together with information on poisoning in pregnancy, harmful chemicals, chemical incidents, antidotes, antivenoms and educational activities.  Information boxes are available for NHS 111 and NHS 24 nurse advisers to enable them to decide on the correct disposition for their callers.  News alerts and newsletter updates are also included. 

 

Hospitals, general practitioners and other health care workers in the UK have direct access to TOXBASE, the clinical toxicology database which is specifically designed for healthcare professionals. TOXBASE is coordinated by the NPIS (Edinburgh Unit), with input from all four NPIS Units. Doctors should consult TOXBASE before telephoning for more expert and specific advice.

 

TOXBASE is available free to UK National Health Service registered users who will normally be departments or surgeries, rather than individuals.  Hospitals and NHS 111 and NHS 24 centres are the major users of the database. There are around 5,000 active users, mainly in the UK and Northern Ireland. TOXBASE is not intended for personal use of UK NHS staff, although group training passwords are available for medical schools and for some other appropriate courses. 

 

In addition to the online website, a TOXBASE app is now available for download onto iPhone and Android devices. The app is free for NHS subscribers and has the added benefit of being available offline. Click for more information on the TOXBASE app.

 

All NPIS Units contribute to and authenticate the content of TOXBASE and it represents the most authoritative source of information available. It should be used by all medical practitioners and other health care professionals working in the NHS as the primary source of poisons information. One of NPIS's major tasks is to ensure this key resource remains up-to-date and relevant. This is a considerable undertaking; 4,599 product entries were created or updated during 2016/17. Substances listed alphabetically include pharmaceuticals, drugs of abuse, cosmetics, toiletries, household products, industrial chemicals, agrochemicals, snakes, insects and plants. It is updated on a regular basis.

 

Accesses to its database have increased steadily since 1999. The total number of TOXBASE user sessions (defined as one logon to the TOXBASE site during which the user may access one or more products several times) increased in 2016/17 to 662,105 (compared to 660,940 in 2015/16), see Figure 1. There was also a significant rise in the use of the TOXBASE app, from 23,217 to 80,929 accesses in 2016/17 (see the TOXBASE app webpage for further detail).

 

Figure 1. Annual number of TOXBASE user sessions, App accesses, telephone enquiries and consultant referrals from 2000 to 2016/17

 

 

TOXBASE is not only used to guide clinical care but is also used as an educational tool, both within the UK and internationally. For the purposes of further detailed analysis in this report, educational and international users have been excluded. User sessions from all NPIS units, the Northern Ireland Regional Medicines and Poison Information Service, and the National Poison Information Centre, Dublin, have also been excluded as poison centres access TOXBASE to answer telephone enquiries, for training/educational purposes, and to access operating procedures or for monograph-writing purposes (NPIS units only). Therefore a total of 602,012 user sessions originating in England, Northern Ireland, Scotland and Wales have been analysed further in this report.

 

TOXBASE user sessions per head of population have increased by 22.8% over the last 6 years, with the largest increases in England and Northern Ireland (Table 1).

 

Table 1. Country of origin of TOXBASE user sessions together with rate of enquiry per 100,000 population in 2010/11 and 2016/17

 

User groups for NPIS are shown in Figure 2, with hospitals, telephone triage services such as NHS 111, paramedics other primary care services being prominent. As in previous years, hospital departments were responsible for the majority (58.9%) of TOXBASE sessions in 2016/17, with most of these originating from emergency departments (354,678; 54.8%).

 

Figure 2. TOXBASE user sessions and telephone enquiries received in 2016/17 (as % of total number of user sessions and telephone enquiries respectively)

 

 

Applying the same criteria as for TOXBASE session data, there were 1,651,369 individual page loads in 2016/17, which is a 2.1% reduction from 1,686,409 in 2015/16. Of note is that the top 10 page loads for hospital and ambulance users are all pharmaceuticals and paracetamol remains the most accessed TOXBASE entry across all user categories (Table 2). As would be expected, the top 10 enquiries from telephone triage services and primary care accesses included agents found in household products.

 

Table 2. TOXBASE page accesses by ingredients and by category of user in 2016/17

 

 

TOXBASE registration

To register for TOXBASE please submit an on-line registration form at www.toxbase.org/Application_for_TOXBASE_registration/

 

Suitable commercial users are charged an annual subscription, and overseas and other non-NHS users may be allowed access by negotiation, subject to UK Health Protection Agency approval. TOXBASE is not available for public access.  

 

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