Study protocol: a randomised controlled trial of multiple and single dose activated charcoal for acute self-poisoning

The case fatality for intentional self-poisoning in rural Asia is 10-30 times higher than in the West, mostly due to the use of highly toxic poisons. Activated charcoal is a widely available intervention that may - if given early - bind to poisons in the stomach and prevent their absorption. Current...

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Bibliographic Details
Published in:BMC emergency medicine 2007-05, Vol.7 (1), p.2-2, Article 2
Main Authors: Eddleston, Michael, Juszczak, Edmund, Buckley, Nick A, Senarathna, Lalith, Mohammed, Fahim, Allen, Stuart, Dissanayake, Wasantha, Hittarage, Ariyasena, Azher, Shifa, Jeganathan, K, Jayamanne, Shaluka, Sheriff, M H Rezvi, Warrell, David A
Format: Article
Language:English
Subjects:
Care and treatment
Charcoal
Drugs
Health aspects
Overdose
Self-poisoning
Statistics
Study Protocol
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Summary:The case fatality for intentional self-poisoning in rural Asia is 10-30 times higher than in the West, mostly due to the use of highly toxic poisons. Activated charcoal is a widely available intervention that may - if given early - bind to poisons in the stomach and prevent their absorption. Current guidelines recommend giving a single dose of charcoal (SDAC) if patients arrive within an hour of ingestion. Multiple doses (MDAC) may increase poison elimination at a later time by interrupting any enterohepatic or enterovascular circulations. The effectiveness of SDAC or MDAC is unknown. Since most patients present to hospital after one hour, we considered MDAC to have a higher likelihood of clinical benefit and set up a study to compare MDAC with no charcoal. A third arm of SDAC was added to help determine whether any benefit noted from MDAC resulted from the first dose or all doses. We set up a randomised controlled trial assessing the effectiveness of superactivated charcoal in unselected adult self-poisoning patients admitted to the adult medical wards of three Sri Lankan secondary hospitals. Patients were randomised to standard treatment or standard treatment plus either a single 50 g dose of superactivated charcoal dissolved in 300 ml of water or six doses every four hours. All patients with a history of poison ingestion were approached concerning the study and written informed consent taken from each patient, or their relative (for unconscious patients or those
ISSN:1471-227X
1471-227X
DOI:10.1186/1471-227X-7-2