How feasible is it to conform to the European guidelines on administration of activated charcoal within one hour of an overdose?

Objectives—The European and American position statement on the use of activated charcoal recommends its administration within an hour of ingestion of a charcoal binding poison. But in reality, this time limit is difficult to follow for the majority of poisoned patients. This study aimed to examine t...

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Bibliographic Details
Published in:Emergency medicine journal : EMJ 2001-09, Vol.18 (5), p.390-392
Main Authors: Karim, A, Ivatts, S, Dargan, P, Jones, A
Format: Article
Language:English
Subjects:
activated charcoal
Adolescent
Adult
Care and treatment
Charcoal
Charcoal - administration & dosage
Drug overdose
Drug Overdose - therapy
Emergency Medical Services - standards
Emergency medicine
England
Europe
Female
Guideline Adherence
Health aspects
Heart attacks
Humans
Irrigation
Male
Middle Aged
overdose
Poisoning
Practice Guidelines as Topic
Pre-Hospital Care
Teaching hospitals
Treatment Outcome
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Summary:Objectives—The European and American position statement on the use of activated charcoal recommends its administration within an hour of ingestion of a charcoal binding poison. But in reality, this time limit is difficult to follow for the majority of poisoned patients. This study aimed to examine the treatment of acutely poisoned patients with activated charcoal in an accident and emergency (A&E) department. Methods—63 patients who had taken potentially serious overdoses and required hospital admission from a London teaching hospital A&E department were identified over a six month period. The patients' case notes were analysed for age, sex, substances taken, and the timing of their management within the A&E department. Results—Median time of arrival after overdose was 136 minutes, and only 15 patients presented within an hour. Ten of these 15 patients were given activated charcoal, and only four of the 10 received it within the one hour limit. Sixteen patients received charcoal outside the time limit. Subanalysis of the individual cases given charcoal shows that triaging is fast (median five minutes), but a significant time delay occurs after this before charcoal is administered (median 21 minutes). Conclusions—These results are likely to be exaggerated in rural hospitals and demonstrate the difficulty of adhering to the recommended guidelines, unless activated charcoal can be safely administered to appropriate patients in the prehospital environment.
ISSN:1472-0205
1472-0213
DOI:10.1136/emj.18.5.390