Detailed information about the involved chemical(s) is most helpful if received prior to patient arrival. Regional poison control centers (PCCs) are already integrated into the emergency medical, HazMat, and Metropolitan Medical Response Systems (MMRS).1112 Another information resource is the Material Safety Data Sheet (MSDS), a document that identifies health and safety information for any product containing hazardous chemicals. MSDSs may be obtained by facsimile from the work-site employer or safety officer, regional PCCs, Chemtrec, NRC, the Internet, and computer databases such as Safetydex™. Included are chemical and physical hazard data as well as information regarding safe use, handling, and storage. Basic first aid procedures are outlined, but advanced medical information usually is not included. While the merit of MSDSs has been questioned,13 at the least they will assist with correct identification and spelling of the chemical agent(s) involved. Limitations of MSDSs use are that they may not exist for all toxic substances, they are not always comprehensive with regard to ingredient listing or toxicity data, they may not be up to date, ingredients listed as "inert" may be toxic, and "trade secret" ingredients may be deleted (although trade secret toxicity data must be listed, and the treating physician is entitled to immediate identity on request). Other resources that may assist with hazard identification determination of toxicity are listed in Table 181-1.
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