Activated charcoal: the untold story.
Introduction. To identify the prevalence and appropriateness of prescribing activated charcoal in the management of acute poisoning and to document patient compliance with treatment.Methods. A prospective study was conducted, between October 1998 and September 1999, on patients attending our accident and emergency department, with a history of overdose. Overdoses were classified as potentially toxic or non-toxic according to the history and/or information received from the National Poisons Information Service.Results. Two hundred and seventy five patients presented following overdose; 17% within one hour, 102 were prescribed charcoal (37.1%) but of these, 40 (39%) refused it, and of the 62 patients (61%) who accepted charcoal only 15 (24.2%) took all that was prescribed. Patients were 5.4 times more likely to take charcoal if they had taken a potentially toxic overdose. Of those who presented within one hour and were judged to have taken a potentially toxic overdose, only three patients took the full-prescribed amount.Conclusion. We report a substantially greater proportion of patients (39%) refusing charcoal than previously reported (9.9%). The widespread availability of TOXBASE Copyright should help redress this discrepancy.
Lynch
Richard M
RM
FRCSI, MMedSci. Specialist Registrar in Accident and Emergency, Hull Royal Infirmary, UK. rlynch@tinyworld.co.uk
Robertson
Robert
R
D002606:Charcoal / Q000627:therapeutic use*; D062787:Drug Overdose / Q000628:therapy*; D006801:Humans; D016013:Likelihood Functions; D011446:Prospective Studies; D013997:Time Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data; D006113:United Kingdom
D002606:Charcoal