Special considerations in gastrointestinal decontamination

Many considerations factor into selecting the most appropriate method of gastrointestinal decontamination used in the poisoned patient. A thorough knowledge of the indications and efficacy as well as contraindications and complications of each modality is critical to the clinician's assessment. This article examines the current utility of syrup of ipecac-induced emesis, orogastric lavage, activated charcoal, cathartics, and whole bowel irrigation. In addition, the role of multiple dose activated charcoal and the controversial issue of the N-acetylcysteine and activated charcoal interaction are discussed.