Out-of-hospital administration of activated charcoal by emergency medical services.
OBJECTIVE
We assess the feasibility of activated charcoal provided by emergency medical services (EMS).


METHODS
This was a 12-month follow-up study on the feasibility of a newly introduced protocol to administer activated charcoal by EMS to acutely poisoned patients before arrival at the hospital. Administration of activated charcoal (50 g or 1 g/kg orally or by nasogastric tube) was considered in 2,047 patients with acute poisoning. Main outcome measures were success rate and elapsed times in and adverse effects of administering charcoal.


RESULTS
Activated charcoal was considered to be an indication for 722 patients (35% of the study population) and was administered to 555 patients. Median elapsed time from poison ingestion to activated charcoal administration was 88 minutes, and median time from activated charcoal administration to hospital arrival was 20 minutes. Activated charcoal was not given to 101 (15.4%) patients, although considered indicated, because of patient refusal (n=72), inability to ingest a charcoal mixture (n=23), technical problems (n=4), or recommendation by the hospital after telephone consultation (n=2). Charcoal caused no reported adverse effects.


CONCLUSIONS
Out-of-hospital activated charcoal administration by EMS is feasible, even in severe poisonings. Adverse events were rare.
Alaspää
Ari O
AO
Helsinki Emergency Medical Services, Poison Information Centre, and Department of Clinical Pharmacology, Helsinki University Central Hospital, Helsinki, Finland. ari.alaspaa@luukku.com <ari.alaspaa@luukku.com>
Kuisma
Markku J
MJ
Hoppu
Kalle
K
Neuvonen
Pertti J
PJ
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002606:Charcoal / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D000075202:Contraindications; D004632:Emergency Medical Services; D005240:Feasibility Studies; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors; D014187:Transportation of Patients
D002606:Charcoal