Systematic review on the use of activated charcoal for gastrointestinal decontamination following acute oral overdose

2021 ◽  
pp. 1-32
Author(s):  
Lotte C. G. Hoegberg ◽  
Greene Shepherd ◽  
David M. Wood ◽  
Jami Johnson ◽  
Robert S. Hoffman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Activated Charcoal ◽  
Gastrointestinal Decontamination

Ascendency of the Black Bottle (Activated Charcoal)

PEDIATRICS ◽  
1987 ◽  
Vol 80 (6) ◽  
pp. 949-951
Author(s):  
JOSEPH GREENSHER ◽  
HOWARD C. MOFENSON ◽  
THOMAS R. CARACCIO
Keyword(s):  
American Academy ◽  
Emergency Room ◽  
Activated Charcoal ◽  
Poison Control ◽  
Poison Control Centers ◽  
Recent Letter ◽  
American Academy Of Pediatrics ◽  
Primary Means ◽  
Significant Change ◽  
Gastrointestinal Decontamination

Previous well-established guidelines for the management of poisonous ingestions in children are undergoing significant change. The time-honored practice of syrup of ipecac-induced vomiting as the primary means of gastrointestinal decontamination now frequently yields to the administration of activated charcoal. Practitioners and emergency room physicians who are increasingly relying on advice from and participation in treatment by regional poison control centers need to understand the rationale behind what many consider contradictions to accepted teaching. A case in point was a recent letter to the American Academy of Pediatrics from a pediatrician questioning the treatment of an ingestion of poison in a toddler.

Gastrointestinal Decontamination

1993 ◽  
Vol 6 (2) ◽  
pp. 48-56
Author(s):  
Gary M. Oderda
Keyword(s):  
Emergency Department ◽  
Gastric Emptying ◽  
Activated Charcoal ◽  
Gastric Lavage ◽  
Human Volunteers ◽  
Gastrointestinal Decontamination

Gastrointestinal decontamination plays an important role in the management of poisoned patients. The use of ipecac syrup has declined, and the use of activated charcoal has increased, during the period 1983 to 1991. If an emetic is used, ipecac syrup is the emetic of choice. If gastric emptying is done in an emergency department, gastric lavage is preferred. Recent studies in animals, human volunteers, and poisoned patients suggest that activated charcoal and a cathartic is as effective, or more effective, than ipecac or lavage plus activated charcoal and a cathartic. As such, activated charcoal and a cathartic should be considered the primary decontamination procedures to be used in a hospital.

scholarly journals Bowel perforation after single-dose activated charcoal

CJEM ◽  
2006 ◽  
Vol 8 (05) ◽  
pp. 358-360 ◽  
Author(s):  
Jason P. Green ◽  
William McCauley
Keyword(s):  
Emergency Department ◽  
Single Dose ◽  
Case Report ◽  
Adverse Effects ◽  
Drug Overdose ◽  
Activated Charcoal ◽  
Literature Search ◽  
Bowel Perforation ◽  
Gastrointestinal Decontamination

ABSTRACT Patients presenting to the emergency department (ED) after medication overdose are often given activated charcoal initially for gastrointestinal decontamination. Complications of charcoal are rare, but do occur. The following case describes a patient with pre-existing undiagnosed diverticular disease who developed sigmoid perforation after a single dose of activated charcoal, given without cathartic for a drug overdose. A literature search revealed no other cases of bowel perforation associated with single-dose activated charcoal. This case report discusses adverse effects associated with activated charcoal and the role of cathartics in gastrointestinal decontamination.

scholarly journals A Prospective Epidemiological Study of Acute Poisoning in Hong Kong

2005 ◽  
Vol 12 (3) ◽  
pp. 156-161 ◽  
Author(s):  
YC Chan ◽  
HT Fung ◽  
CK Lee ◽  
SH Tsui ◽  
HK Ngan ◽  
...  
Keyword(s):  
Hong Kong ◽  
Activated Charcoal ◽  
Carbon Monoxide Poisoning ◽  
Demographic Data ◽  
Acute Poisoning ◽  
Uneventful Recovery ◽  
Sleeping Pills ◽  
Accident And Emergency ◽  
Significant Disability ◽  
Gastrointestinal Decontamination

Objective To update our epidemiological knowledge of acute poisoning in Hong Kong. Methods A multi-centred prospective study was conducted for six months in six major accident and emergency departments in Hong Kong. A specially designed form was used to collect demographic data, type of poison involved, cause of poisoning, management, disposal as well as final outcome of the poisoned patients. Results A total of 1,467 patients (male: 588, female: 879) were included in the study. Most of them were young adults (32% were between 20 and 40 years old). Suicidal attempt (64%) was the most common cause of poisoning. Notably, 379 (26%) patients took more than one poison. Among the 2,007 counts of poison taken, sleeping pills (24%) and analgesics (18%) were the most commonly used drugs and paracetamol was the commonest single ingredient involved in poisoning. Most patients were treated with supportive measures, and about 40% and 15% of the patients were given gastrointestinal decontamination and specific antidotes respectively in their management, in which activated charcoal and N-acetylcysteine were the most common. Concerning disposal from the emergency department, 91% of the poisoned cases required in-patient management. Most patients had an uneventful recovery but 5 (0.3%) had significant disability and 21 (1.4%) died. Suicidal carbon monoxide poisoning was the leading cause of mortality in our study. Conclusions Most acute poisonings in Hong Kong were suicidal in nature and paracetamol was the commonest agent. Activated charcoal was the most commonly used decontamination method and most patients had an uneventful recovery.

scholarly journals Evaluatıon of Basal Metabolıc Panels in Drug Poısonıng Who Applıed Wıth Actıvated Charcoal

2018 ◽  
Keyword(s):  
Chronic Diseases ◽  
Activated Charcoal ◽  
Suicide Attempts ◽  
Active Charcoal ◽  
Reference Ranges ◽  
Chronic Medication ◽  
Significant Change ◽  
The Difference ◽  
Clinically Significant ◽  
Gastrointestinal Decontamination

Introduction: Poisoning is the hindering of the bodily functions of the organism after it encounters a toxic factor. Poisoning may be the result of suicide attempts, overdose, or adverse effects. Some of these patients require gastrointestinal decontamination. The most commonly used material for this is activated charcoal. Activated charcoal may cause side-effects in the human body. Purpose: This study examines the effects of active charcoal on the basic metabolic panel when used on patients for any reason. Material and Method: This is a retrospective, single-center, and observational study. The subjects of the study are patients that were admitted to the emergency room between 01.01.2012 and 30.07.2017 with various cases of poisoning, and who underwent activated charcoal treatment. The ingested drugs were classified according to their active substances. The patients were evaluated with regard to their age, gender, vital findings, chronic diseases, chronic medication, whether they were referred from external centres, and whether or not they received active charcoal. Results: The changes in patients' levels of pCO2, Na, Ca, BUN, creatinine and blood glucose were found to be statistically significant. However, since all the obtained values were within reference ranges, the difference was not considered to be clinically significant. No significant change was observed in blood pH, K and Mg concentrations. Conclusion: This study is a first in the literature to indicate that there is no clinically significant change in the basic metabolic panels of patients who received active charcoal treatment. This study has shown that active charcoal treatment can be applied to patients with chronic diseases.

Management of Acute Poisoning With Activated Charcoal

PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 324-329
Author(s):  
Donald G. Corby ◽  
Walter J. Decker
Keyword(s):  
Emergency Room ◽  
Activated Charcoal ◽  
First Aid ◽  
Acute Poisoning ◽  
Complexing Agent ◽  
Valuable Adjunct ◽  
Repeated Doses ◽  
Clinical Illness ◽  
Gastrointestinal Decontamination

Activated charcoal has been shown to be an effective complexing agent for many drugs. The quantitative in vivo evidence accumulated thus far indicates that this agent can be a very valuable adjunct in the initial phases of treating acute ingestions not only in the emergency room but also as a first aid measure in the home. It is well tolerated in extremely high single doses, and there is no known contraindication to its use in treatment of acute drug ingestion. It is immediately effective upon ingestion and can be given safely by nonprofessionals; hence, its inclusion in household first-aid supplies is warranted. In the emergency room, activated charcoal can be administered by lavage tube to an unconscious patient in large and repeated doses and can be continued throughout the acute phase of the clinical illness. The effectiveness of activated charcoal can be enhanced by emesis induced by apomorphine before or after charcoal administration. Since charcoal effectively adsorbs ipecac, syrup of ipecac should be given before the activated charcoal. Although it is not uniformly efficacious for all drugs, activated charcoal appears to be a generally useful adjunct for gastrointestinal decontamination.

scholarly journals Evaluatıon of Basal Metabolıc Panels in Drug Poısonıng Who Applıed Wıth Actıvated Charcoal

2018 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Chronic Diseases ◽  
Activated Charcoal ◽  
Suicide Attempts ◽  
Active Charcoal ◽  
Reference Ranges ◽  
Chronic Medication ◽  
Significant Change ◽  
The Difference ◽  
Clinically Significant ◽  
Gastrointestinal Decontamination

Introduction: Poisoning is the hindering of the bodily functions of the organism after it encounters a toxic factor. Poisoning may be the result of suicide attempts, overdose, or adverse effects. Some of these patients require gastrointestinal decontamination. The most commonly used material for this is activated charcoal. Activated charcoal may cause side-effects in the human body. Purpose: This study examines the effects of active charcoal on the basic metabolic panel when used on patients for any reason. Material and Method: This is a retrospective, single-center, and observational study. The subjects of the study are patients that were admitted to the emergency room between 01.01.2012 and 30.07.2017 with various cases of poisoning, and who underwent activated charcoal treatment. The ingested drugs were classified according to their active substances. The patients were evaluated with regard to their age, gender, vital findings, chronic diseases, chronic medication, whether they were referred from external centres, and whether or not they received active charcoal. Results: The changes in patients' levels of pCO2, Na, Ca, BUN, creatinine and blood glucose were found to be statistically significant. However, since all the obtained values were within reference ranges, the difference was not considered to be clinically significant. No significant change was observed in blood pH, K and Mg concentrations. Conclusion: This study is a first in the literature to indicate that there is no clinically significant change in the basic metabolic panels of patients who received active charcoal treatment. This study has shown that active charcoal treatment can be applied to patients with chronic diseases.

The Treatment of Overdose–Time for a Change?

2000 ◽  
Vol 45 (3) ◽  
pp. 75-76 ◽  
Author(s):  
A.C. McGuffie ◽  
S.C. Wilkie ◽  
G.W. Kerr
Keyword(s):  
Emergency Management ◽  
Activated Charcoal ◽  
Response Rate ◽  
Gastric Lavage ◽  
Information Service ◽  
Postal Questionnaire ◽  
Acute Overdose ◽  
The Uk ◽  
Gastrointestinal Decontamination ◽  
Poisons Information

To determine emergency management of overdose relating to gastrointestinal decontamination procedures in Scottish Accident & Emergency (A & E) Departments. A postal questionnaire was sent to the 28 main A & E Departments in Scotland. There was a 75% response rate. Nineteen departments (90%) continue to perform gastric lavage, with the majority carrying out this procedure more than one hour post-ingestion of commonly presenting overdoses. Sixteen departments (76%) regularly administer activated charcoal and four (19%) use syrup of ipecacuanha. Twenty departments (95%) had access to Toxbase. The majority of respondents (86%) feel there is a need for standardisation of treatment in acute overdose. Despite the availability of guidelines provided by the UK National Poisons Information Service and the Position Statements, there is no consensus in the actual management of acute overdose among Scottish A&E departments.

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