HWN Suggests

Gastrointestinal decontamination in the acutely poisoned patient

The literature suggests that previously, widely used, aggressive approaches including the use of ipecac syrup, gastric lavage, and cathartics are now rarely recommended. Whole bowel irrigation is still often recommended for slow-release drugs, metals, and patients who "pack" or "stuff" foreign bodies filled with drugs of abuse, but with little quality data to support it. Activated charcoal (AC), single or multiple doses, was also a previous mainstay of GI decontamination, but the utility of AC is now recognized to be limited and more time dependent than previously practiced. These recommendations have resulted in several treatment guidelines that are mostly based on retrospective analysis...

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 ToxCard: GI Decon

The options for GI decontamination for poisoned patients are activated charcoal, gastric lavage and whole bowel irrigation.

Articles of Interest

Gastric Lavage: Position Paper Update

Gastric lavage should not be performed routinely, if at all, for the treatment of poisoned patients.

Gastrointestinal Decontamination

The role for digestive tract decontamination depends on: severity of poisoning, time from ingestion, risk of intervention.

Peds Poisonings

Despite its widespread use, gastrointestinal decontamination has not been demonstrated to be beneficial and is generally indicated only in specific circumstances.

To Decontaminate or Not to Decontaminate? The Balance Between Potential Risks and Foreseeable Benefits

To prevent absorption, single-dose activated charcoal may be used in most patients. For some specific ingestions, such as large ingestions (because there appears to be a dose-response relationship), activated charcoal may also be repeated one time or more.