Pediatric ingestions: charcoal alone versus ipecac and charcoal.
OBJECTIVE
To determine the effect of syrup of ipecac (SOI) on time to receive and retention of activated charcoal (AC) and on total ED time.


METHODS
During a two-year period, patients were enrolled in a prospective, randomized, unblinded, controlled trial.


METHODS
All patients were recruited and studied in a pediatric emergency department.


METHODS
Seventy children less than 6 years old (mean age, 2.4 +/- 0.2 years) who presented with mild-to-moderate acute oral ingestions.


METHODS
Group 1 received SOI before AC. Group 2 received only AC.


RESULTS
Group 1 patients took significantly longer to receive AC than group 2 from the time of ED arrival (2.6 +/- 0.1 vs 0.9 +/- 0.1 hours, P less than .0001). Group 1 children were significantly more likely to vomit AC than were group 2 children (18 of 32 vs six of 38, P less than .001). Patients receiving SOI who were subsequently discharged spent significantly more time in the ED than those receiving only AC (4.1 +/- 0.2 vs 3.4 +/- 0.2 hours, P less than .05).


CONCLUSIONS
Ipecac delays the administration of AC, hinders its retention, and prolongs ED time in pediatric ingestion patients. These data support the recommendation that AC alone should be the gastrointestinal decontamination method of choice for the mild-to-moderate pediatric ingestion patient presenting to an ED.
Division of Emergency Medicine, Children's Hospital of Buffalo, New York 14222.
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AE
Kornberg
J
J
Dolgin
D002606:Charcoal / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007486:Ipecac / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011041:Poisoning / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors
D002606:Charcoal; D007486:Ipecac