Gastric emptying in acute overdose: a prospective randomised controlled trial

Area of Science:

• Emergency Medicine
• Clinical Toxicology
• Pharmacology

Background:

• Acute oral overdose is a common emergency presentation.
• Current treatment protocols often include gastric emptying and activated charcoal.
• The necessity of gastric emptying in conjunction with activated charcoal requires further investigation.

Purpose of the Study:

• To compare the efficacy and safety of activated charcoal alone versus gastric emptying plus activated charcoal in adults with acute oral overdose.
• To determine if gastric emptying can be omitted from standard treatment protocols.

Main Methods:

• A prospective randomized controlled trial involving 876 adult patients presenting with acute oral overdose.
• Patients were allocated to either gastric emptying plus activated charcoal (E group) or activated charcoal alone (NE group).
• Outcomes assessed included clinical course, hospital stay, and complications within the first six hours post-treatment.

Main Results:

• No significant differences were observed in age, sex, overdose severity, or outcomes between the E and NE groups.
• A statistically significant difference was noted in the mean interval between presentation and charcoal administration (longer in the E group).
• Stratified analysis by overdose severity or time to presentation did not reveal significant outcome differences.

Conclusions:

• Gastric emptying can be safely omitted from the treatment protocol for adults following acute oral overdose.
• Activated charcoal administration alone is an effective and sufficient intervention.
• This finding simplifies overdose management and may reduce unnecessary procedures.