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Activated charcoal: the untold story
Richard M Lynch1, Robert Robertson
1FRCSI, MMedSci. Specialist Registrar in Accident and Emergency, Hull Royal Infirmary, UK. rlynch@tinyworld.co.uk
Many patients refuse activated charcoal (AC) for acute poisoning, with 39% declining treatment. Compliance is low even for toxic overdoses, highlighting a need for improved AC administration strategies.
Area of Science:
- Emergency Medicine
- Clinical Toxicology
Background:
- Activated charcoal (AC) is a common treatment for acute poisoning.
- Patient compliance and refusal rates for AC are not well-documented.
Purpose of the Study:
- To determine the prevalence and appropriateness of prescribing AC.
- To assess patient compliance with AC treatment in acute overdose cases.
Main Methods:
- Prospective study of patients presenting with overdose to an accident and emergency department.
- Classification of overdoses as potentially toxic or non-toxic.
- Documentation of AC prescription, refusal, and adherence rates.
Main Results:
- 37.1% of 275 overdose patients received AC; 39% refused it.
- Only 24.2% of patients who accepted AC completed the prescribed amount.
- Patients with potentially toxic overdoses were more likely to accept AC.
Conclusions:
- A higher proportion of patients refused AC than previously reported.
- Low adherence suggests challenges in AC management, even for toxic ingestions.
- Enhanced resources like TOXBASE may improve AC administration.
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