"Is she awake? Alert? Who is its manufacturer? Do you know how much she swallowed?"

"How much does he weigh? Do you have any ipecac in your house?"

The atmosphere at the National Capital Poison Center is electric, as three nurses juggle a bank of flashing phones, fielding life-and-death questions from anguished callers.

Each year, there are 1.4 million accidental poisonings in the United States, and the first contact for many desperate parents is a center like this one, located at Georgetown University Medical Center. Most centers are staffed by nurses whose bible is Poisondex, a computerized listing of more than 650,000 substances from shoe polish to lawnmower oil. Each day at every poison center around the country, as many as 150 frantic parents, babysitters, grandparents and siblings call for help.

"Do you have ipecac?" asks Georgetown's Jane Elshami, a nurse, as she reassures the mother of a 15-month-old boy who managed to open a bottle of antihistamine tablets; his mother does not know how many he chewed. As Elshami talks the woman through the process, they determine that three pills are missing.

"Your little guy's dose of ipecac is going to be three teaspoons," she tells the mother. "That sounds like a lot, but he needs it. Give him a glass of anything he likes with it except milk. It normally will take 20 minutes for him to throw up. It's not a big build-up; he'll throw up a couple of times in a row. Get him settled, don't give him any food or fluid for one hour and call me back."

This exchange lasts less than 40 seconds. Within an instant of hanging up, Elshami is on another call, this time from the mother of a 6-year-old who drank some cough medicine. As is routine, nurses will call both mothers back in a few hours and sometimes daily, until a child has recovered.

The lifesavers in the world of poison control are syrup of ipecac, which induces vomiting, and in more serious cases, processed charcoal. The charcoal neutralizes some substances, such as pesticides, that have been swallowed. In both cases, the recommended amount is based on body weight.

Government regulations requiring child-resistant caps, plus the existence of poison centers and the proliferation of devices such as cabinet locks, have made dramatic differences. More than 90 percent of all poisonings occur at home, and children under 3 are the most frequent victims. In 1962, nearly 500 children across the U.S. died from accidental poisonings. Today, fewer than 60 die annually.

Before child-proof caps, children's aspirin and painkillers were sold in large, economy sizes, which may have saved a few dollars but contributed to accidental overdoses. Now, children's medicine comes in smaller packages, and most adult medicines have caps that a child cannot easily open. As a result, household cleaners have become the biggest threat, as sprays, air fresheners and toilet disinfectants fill storage closets.

"It makes everyone's job harder, because some poisons have been made attractive or to look like food," says Toby Litovitz, medical director of the Georgetown Hospital center and president-elect of the American Association of Poison Control Centers. "Walk down the aisles of {a grocery store} and see all the roses and lemons on furniture polish."

Medicines remain hazardous, in part because some have been made to taste good. Chocolate-flavored laxatives are a frequent problem, because they resemble candy. Children's colored vitamins, now in appealing animal shapes, also cause overdoses, as youngsters sort through bottles to find their favorites.

Other products thought to be benign, like mouthwashes and eye drops, have proved fatal to children. Medicine taken to prevent bed-wetting, such as imipramine, is toxic in large doses. Vitamins for pregnant women can kill children because they contain large amounts of iron. Vanilla, almond and other extracts used in baking contain enough alcohol to cause problems for children.

There are 319 poison centers nationwide, but only 36 are certified by the American Association of Poison Control Centers. In order to qualify, a center must have a physician on call round the clock and its staff members must have worked fulltime for one year. In addition, they must have handled at least 2,000 emergency telephone calls, passed a three-hour written exam and be recommended by a poison control center director.

Most centers are underfunded, and some operate largely because of the commitment of their staffs. Many centers are financed by hospitals; others, such as those in New York City, are part of government health departments. In New Jersey, hospitals by law must contribute to the centers' upkeep.

Before there were poison centers, it was not unusual for hospital emergency rooms and pediatricians to make frantic, usually after-hours calls to manufacturers, trying to determine the ingredients of the oven cleaner or insecticide. The first poison control center began in Chicago in 1957. The concept expanded, with as many as 641 centers, many rudimentary, by 1976. In some cities, hospitals began centers as marketing ploys, often in competition with neighboring hotlines. In Minneapolis, for example, there were 11 separate poison centers by 1969.

Despite all the well-intentioned help, the lack of coordination caused duplication and confusion, which prompted hotlines to consolidate into regional centers. But serious problems remained in getting fast information on product ingredients.

In frustration, Barry Rumack, a Denver toxicologist, started a data bank on poisons in 1974. His company now operates Poisondex, which has been successful in obtaining information about most medicines and consumer products from manufacturers. Poison centers buy the service, which lists ingre- dients and treatments on computer disks and microfiche.

Most centers are busiest beginning in the late afternoon, when parents and babysitters are preoccupied with the logistics of dinner and household chores. Saturday mornings are another busy time, as parents try to sleep while children play, watch TV and, too often, explore what's in bottles and cans in the house.

Illegal drugs also are a hazard for children. Nurse Rose Ann Soloway of the Georgetown center recalls a particularly rough day when her first call concerned a 2-year-old who had swallowed several rocks of crack. Less than two hours later, another 2-year-old ate half a marijuana cigarette soaked in PCP. Later that day, a 5-month-old had seizures from exposure to his parents' heroin. "All the kids wound up fine, at least medically," she said. "But it's just a wrenching situation."

Margaret Engel is director of the Alicia Patterson Journalism Foundation, based in Washington.

Call the poison control hotline for help (202-625-3333). Have the product at hand in order to read from the label. Do not give children salt to induce vomiting. Do not administer syrup of ipecac unless directed to by a medical professional. In several cases, vomiting speeds the poisoning process.

For inhaled poisons, a child needs fresh air or oxygen. Give artificial respiration if the child is not breathing.

For poisons on the skin, remove the contaminated clothing and flood the skin with water for 10 minutes and then wash gently with soap and water.

Know which hospital emergency rooms are nearby, or have the number of an ambulance service posted. -- Margaret Engel