Emergency Medicine Book

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Activated Charcoal

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  1. Indications
    1. Patient presents within 60 minutes of ingestion
    2. Overdose or Toxin Ingestion
      1. Antidepressants
      2. Aspirin
      3. Aminophylline
      4. Barbiturates
      5. Carbamazepine
      6. Digitalis
      7. Dilantin
      8. Dapsone
  2. Advantages
    1. Few side effects
    2. Most effective method for Unknown Ingestion
  3. Substances for which charcoal is ineffective
    1. Pesticides
    2. Hydrocarbons
    3. Alcohols
    4. Acids
    5. Alkali
    6. Iron
    7. Lithium
    8. Solvents
  4. Complications
    1. Intestinal Obstruction
    2. Aspiration pneumonitis
  5. Safety
    1. Multiple charcoal doses are safe with rare complication
      1. Dorrington (2003) Ann Emerg Med 41:370
  6. Dose
    1. Dose
      1. Adult: 25 to 100 grams in 300 to 800 ml water
      2. Child (<12 years): 0.5-1.0 g/kg in 300 ml water
    2. May repeat dose every 2-4 hours if bowel sounds present
    3. Additional measures
      1. Consider concurrent use of Antiemetic suppository
      2. Consider administering via Nasogastric Tube

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