[Role of medicinal coal in primary management of poisoning]

Primary detoxication by ipecac-induced emesis or gastric lavage is incomplete. In mild to moderate childhood poisoning administration of activated charcoal alone without gastric emptying is often more effective, because it binds toxins promptly. In-vitro and in-vivo studies of many substances have shown good adsorption to activated charcoal (e.g. digitalis, beta-blocking agents, phenobarbitone, carbamazepine, theophylline). If in-vitro adsorption is moderate to poor, administration of activated charcoal might nevertheless prove clinically valuable by altering the severity of symptoms such as has been shown with acetaminophen, salicylates or organophosphate insecticide intoxications. Possible risks are shown and dosage regimens of activated charcoal are given alongside an evaluation of additional cathartics in the initial treatment of childhood poisonings. The role of repeated doses of activated charcoal as a method of secondary detoxication in comparison with hemoperfusion techniques and its significance in clinical routine is pointed out. General conclusion: In mild to moderate childhood poisoning early administration of activated charcoal alone after consultation of pediatrician and/or poison center specialists is an adequate therapy.