Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions

Timothy E Albertson, Robert W. Derlet, Garrett E. Foulke, MC Minguillon, SR Tharratt

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

A prospective, randomized clinical trial compared the clinical effectiveness of syrup of ipecac and activated charcoal to that of activated charcoal alone in the treatment of acute toxic ingestions. Two hundred adult patients with mild to moderate oral overdoses were entered into the trial. Patients receiving only activated charcoal were discharged from the emergency department in significantly (P ≤ .05) less time than those receiving both syrup of ipecac and activated charcoal (6.0 ± 0.3 vs 6.8 ± 0.2 hours, respectively). The percentage of patients requiring nonpsychiatric hospitalizations was not significantly different between the two groups (11.2% vs 14.0%, respectively). For the hospitalized patients, the length of time spent in the ICU and in the hospital was not statistically different between the two groups. A complication rate of 5.4% was found with the ipecac and activated charcoal treatment compared with a 0.9% complication rate in the activated charcoal group (P ≤ .05). Three episodes of aspiration pneumonitis occurred after administration of ipecac and activated charcoal, while no episodes of aspiration were noted after treatment with only activated charcoal. Together, these data are consistent with the recommendation that ED treatment with activated charcoal alone be the gastrointestinal decontamination procedure of choice for the routine mildly-to-moderately orally poisoned adult patient.

Original languageEnglish (US)
Pages (from-to)56-59
Number of pages4
JournalAnnals of Emergency Medicine
Volume18
Issue number1
DOIs
StatePublished - 1989

Fingerprint

Ipecac
Poisons
Charcoal
Eating
Therapeutics
Decontamination
Hospital Emergency Service
Pneumonia
Hospitalization
Randomized Controlled Trials

Keywords

  • activated charcoal
  • ipecac
  • toxic ingestion

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions. / Albertson, Timothy E; Derlet, Robert W.; Foulke, Garrett E.; Minguillon, MC; Tharratt, SR.

In: Annals of Emergency Medicine, Vol. 18, No. 1, 1989, p. 56-59.

Research output: Contribution to journalArticle

Albertson, Timothy E ; Derlet, Robert W. ; Foulke, Garrett E. ; Minguillon, MC ; Tharratt, SR. / Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions. In: Annals of Emergency Medicine. 1989 ; Vol. 18, No. 1. pp. 56-59.
@article{a635f0b050554816867382c030ce7559,
title = "Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions",
abstract = "A prospective, randomized clinical trial compared the clinical effectiveness of syrup of ipecac and activated charcoal to that of activated charcoal alone in the treatment of acute toxic ingestions. Two hundred adult patients with mild to moderate oral overdoses were entered into the trial. Patients receiving only activated charcoal were discharged from the emergency department in significantly (P ≤ .05) less time than those receiving both syrup of ipecac and activated charcoal (6.0 ± 0.3 vs 6.8 ± 0.2 hours, respectively). The percentage of patients requiring nonpsychiatric hospitalizations was not significantly different between the two groups (11.2{\%} vs 14.0{\%}, respectively). For the hospitalized patients, the length of time spent in the ICU and in the hospital was not statistically different between the two groups. A complication rate of 5.4{\%} was found with the ipecac and activated charcoal treatment compared with a 0.9{\%} complication rate in the activated charcoal group (P ≤ .05). Three episodes of aspiration pneumonitis occurred after administration of ipecac and activated charcoal, while no episodes of aspiration were noted after treatment with only activated charcoal. Together, these data are consistent with the recommendation that ED treatment with activated charcoal alone be the gastrointestinal decontamination procedure of choice for the routine mildly-to-moderately orally poisoned adult patient.",
keywords = "activated charcoal, ipecac, toxic ingestion",
author = "Albertson, {Timothy E} and Derlet, {Robert W.} and Foulke, {Garrett E.} and MC Minguillon and SR Tharratt",
year = "1989",
doi = "10.1016/S0196-0644(89)80314-2",
language = "English (US)",
volume = "18",
pages = "56--59",
journal = "Annals of Emergency Medicine",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions

AU - Albertson, Timothy E

AU - Derlet, Robert W.

AU - Foulke, Garrett E.

AU - Minguillon, MC

AU - Tharratt, SR

PY - 1989

Y1 - 1989

N2 - A prospective, randomized clinical trial compared the clinical effectiveness of syrup of ipecac and activated charcoal to that of activated charcoal alone in the treatment of acute toxic ingestions. Two hundred adult patients with mild to moderate oral overdoses were entered into the trial. Patients receiving only activated charcoal were discharged from the emergency department in significantly (P ≤ .05) less time than those receiving both syrup of ipecac and activated charcoal (6.0 ± 0.3 vs 6.8 ± 0.2 hours, respectively). The percentage of patients requiring nonpsychiatric hospitalizations was not significantly different between the two groups (11.2% vs 14.0%, respectively). For the hospitalized patients, the length of time spent in the ICU and in the hospital was not statistically different between the two groups. A complication rate of 5.4% was found with the ipecac and activated charcoal treatment compared with a 0.9% complication rate in the activated charcoal group (P ≤ .05). Three episodes of aspiration pneumonitis occurred after administration of ipecac and activated charcoal, while no episodes of aspiration were noted after treatment with only activated charcoal. Together, these data are consistent with the recommendation that ED treatment with activated charcoal alone be the gastrointestinal decontamination procedure of choice for the routine mildly-to-moderately orally poisoned adult patient.

AB - A prospective, randomized clinical trial compared the clinical effectiveness of syrup of ipecac and activated charcoal to that of activated charcoal alone in the treatment of acute toxic ingestions. Two hundred adult patients with mild to moderate oral overdoses were entered into the trial. Patients receiving only activated charcoal were discharged from the emergency department in significantly (P ≤ .05) less time than those receiving both syrup of ipecac and activated charcoal (6.0 ± 0.3 vs 6.8 ± 0.2 hours, respectively). The percentage of patients requiring nonpsychiatric hospitalizations was not significantly different between the two groups (11.2% vs 14.0%, respectively). For the hospitalized patients, the length of time spent in the ICU and in the hospital was not statistically different between the two groups. A complication rate of 5.4% was found with the ipecac and activated charcoal treatment compared with a 0.9% complication rate in the activated charcoal group (P ≤ .05). Three episodes of aspiration pneumonitis occurred after administration of ipecac and activated charcoal, while no episodes of aspiration were noted after treatment with only activated charcoal. Together, these data are consistent with the recommendation that ED treatment with activated charcoal alone be the gastrointestinal decontamination procedure of choice for the routine mildly-to-moderately orally poisoned adult patient.

KW - activated charcoal

KW - ipecac

KW - toxic ingestion

UR - http://www.scopus.com/inward/record.url?scp=0024497640&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024497640&partnerID=8YFLogxK

U2 - 10.1016/S0196-0644(89)80314-2

DO - 10.1016/S0196-0644(89)80314-2

M3 - Article

C2 - 2562913

AN - SCOPUS:0024497640

VL - 18

SP - 56

EP - 59

JO - Annals of Emergency Medicine

JF - Annals of Emergency Medicine

SN - 0196-0644

IS - 1

ER -