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Related Experiment Videos

Special considerations in gastrointestinal decontamination

J Perrone1, R S Hoffman, L R Goldfrank

  • 1Department of Medical Toxicology, New York City Poison Control Center, New York.

Emergency Medicine Clinics of North America
|May 1, 1994
PubMed
Summary

Choosing the right gastrointestinal decontamination method for poisoned patients requires understanding indications, efficacy, and risks. This review covers emesis, lavage, activated charcoal, cathartics, and whole bowel irrigation, including special considerations.

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Area of Science:

  • Toxicology
  • Emergency Medicine
  • Clinical Pharmacology

Background:

  • Gastrointestinal decontamination is a cornerstone of managing poisoned patients.
  • Selecting the optimal method requires careful consideration of patient factors and poison characteristics.

Purpose of the Study:

  • To review the current evidence and clinical utility of various gastrointestinal decontamination methods.
  • To discuss the indications, contraindications, efficacy, and complications associated with each modality.
  • To address specific issues like multiple-dose activated charcoal and drug interactions.

Main Methods:

  • Review of existing literature on gastrointestinal decontamination techniques.
  • Analysis of clinical guidelines and expert consensus.

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  • Discussion of specific agents including syrup of ipecac, activated charcoal, cathartics, and whole bowel irrigation.

    • Main Results:

    • Syrup of ipecac is rarely used due to limited efficacy and risk of complications.
    • Activated charcoal is a widely used and effective agent, particularly when administered early.
    • Whole bowel irrigation is indicated for certain ingestions, such as sustained-release formulations and body packers.

    Conclusions:

    • The choice of gastrointestinal decontamination should be individualized based on the specific poison, time since ingestion, and patient condition.
    • Clinicians must be aware of the potential benefits and harms of each method.
    • Further research is needed to clarify optimal strategies for specific poisoning scenarios.