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Single dose activated charcoal for gut decontamination: Application by medical non-professionals -a prospective study
Rudolf Pfab1, Sabrina Schmoll1, Gabriele Dostal1
1Division of Clinical Toxicology, Department of Internal Medicine 2, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675, Munich, Germany.
Context:
Oral activated charcoal (AC) for toxin absorption should be applied as soon as possible. Extra-hospital AC-application on site by medical laypersons with pre-emptive obtained AC may save time, but may be inferior to AC-application by medical professionals.
Objective:
1) Availability and incidence of pre-emptive stockpiling of AC on site in the German region Bavaria 2) time saved by AC-stockpiling and application on site, 3) quality of AC-application defined by completeness of the applied AC-dose, time needed, incidence of side-effects in lay-care and in professional-care, considering confounding variables: AC-formulation/powder/tablets, recommended AC-dose, patient's age.
Method:
telephone-interviews in cases with AC-recommendation by a Poison Information Centre (PIC). Lay-care was suggested according to risk-assessment by PIC. Ingestion sites were classified as either apt for AC-stockpiling or not apt.
Results:
1) availability: In Bavaria only 20%-22% of eligible cases had AC on-hand, 2) time-saving was at least 14 min. 3) Lay-care/professional-care or patient's age had no significant influence on the completeness of the applied AC-dose, which was higher with AC as powder but negatively correlated with the recommended AC-dose. No significant difference was seen with time needed for application and incidence of side-effects.
Conclusion:
pre-emptive AC-stocking should be encouraged.
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