The Poison center nurses are unseen heroes working behind the scenes to help save lives. Last night, Tammy Smith went above and beyond in her efforts to assist the treatment team at the bedside of a patient bitten by a rare African Viper. The Poison Center covers about 57 hospitals and free-standing ED's and a population of approximately 3.2 million people. This requires an ability to triage multiple emergency calls according to severity and formulate a poisoning management plan with speed and accuracy. All Poison Centers keep something called an Antivenom Index. This is a joint project between America's zoos and Poison Centers to keep a centralized list of places that have rare venomous snakes and other animals and places that have antivenom to treat bites. Tammy's patient (we'll call him Mr. X) was bitten just after midnight on a weekend. The kind of venom rushing through his tissues is a particularly nasty type. There is no hope for survival with a severe bite if antivenin isn't administered. It causes the red blood cells to lyse and they begin to bleed from every orifice. In between giving recommendations for supportive care to the physicians at the bedside, Tammy initiated toxicology consults for this patient and then began the search for antivenin at 2 am. Through the night, she continued to handle multiple other cases and calls while making dozens of calls to zoos, aquariums and more to locate the antivenin needed. Several times the numbers were out of date or just went to zoo offices which were closed. Finally, she got a zookeeper who had the cell numbers of the current staff and she was able to get some people awake at the National Zoo in DC. Through her work, the first vials were on the way--and just in the nick of time! By 8 am the first dose of antivenin was infusing. Starting Sunday morning, our next nurse took over to search for additional doses. Tammy made it home for some well-deserved rest. Her patient will probably never know about the nurse who did so much for him, but I know she exhibits the true spirit of a DAISY nurse.