Abstract
The management of acute poisoning remains an important part of accident and emergency (A&E) care. Three gastric decontamination procedures have been widely used: gastric lavage, ipecac, and activated charcoal. Their role has recently been reviewed and position statements developed by working groups of the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. These have important implications for A&E, as they indicate that activated charcoal is now the agent of choice for most poisons, but than in most situations it is probably only effective if given within an hour of overdose. Ipecac is effectively obsolete and gastric lavage has a narrow range of indications, principally for potentially serious amounts of agents not adsorbed by charcoal. Protocols for care of overdose patients should be modified accordingly.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Auerbach P. S., Osterloh J., Braun O., Hu P., Geehr E. C., Kizer K. W., McKinney H. Efficacy of gastric emptying: gastric lavage versus emesis induced with ipecac. Ann Emerg Med. 1986 Jun;15(6):692–698. doi: 10.1016/s0196-0644(86)80427-9. [DOI] [PubMed] [Google Scholar]
- Blake D. R., Bramble M. G. Is there excessive use of gastric lavage in the treatment of self-poisoning? Lancet. 1978 Dec 23;2(8104-5):1362–1364. doi: 10.1016/s0140-6736(78)91991-8. [DOI] [PubMed] [Google Scholar]
- Corby D. G., Decker W. J., Moran M. J., Payne C. E. Clinical comparison of pharmacologic emetics in children. Pediatrics. 1968 Aug;42(2):361–364. [PubMed] [Google Scholar]
- Pond S. M., Lewis-Driver D. J., Williams G. M., Green A. C., Stevenson N. W. Gastric emptying in acute overdose: a prospective randomised controlled trial. Med J Aust. 1995 Oct 2;163(7):345–349. doi: 10.5694/j.1326-5377.1995.tb124625.x. [DOI] [PubMed] [Google Scholar]
- Thompson A. M., Robins J. B., Prescott L. F. Changes in cardiorespiratory function during gastric lavage for drug overdose. Hum Toxicol. 1987 May;6(3):215–218. doi: 10.1177/096032718700600307. [DOI] [PubMed] [Google Scholar]