Trends in emergency department use of gastric lavage for poisoning events in the United States, 1993-2003.
OBJECTIVE
To determine current trends in the use of gastric decontamination for the emergency department (ED) treatment of overdose patients.


METHODS
In the National Health Ambulatory Medical Care Survey (NHAMCS), a weighted sampling of U.S. EDs, overdose-related visits were examined using ICD-9 CM E codes and NHAMCS' "reason-for-visit" classification.


RESULTS
From 1993 to 2003 there were an estimated 11.68 million ED-treated poisoning events. Some 13.7% of those treated were lavaged. Rates fell significantly, from an annual average of 18.7% of cases during 1993-97 to 10.3% during 1998-2003 (p < 0.001). Controlling for year, urgency, and admission status in multivariate logistic modeling, lavage was significantly and positively associated with private insurance payor status, younger age (<30), female gender, white race, 8 PM-8 AM presentation, and intentional rather than unintentional overdose.


CONCLUSIONS
ED use of gastric lavage in poisoned patients has decreased significantly over the past decade but varies by demographic and non-clinical factors.
Larkin
Gregory Luke
GL
Department of Surgery, Emergency Medicine & Public Health, UT Southwestern Medical School, Dallas, Texas, USA. Gluke.larkin@yale.edu
Claassen
Cindy
C
D000328:Adult; D004632:Emergency Medical Services / Q000379:methods / Q000639:trends*; D005260:Female; D005751:Gastric Lavage / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011041:Poisoning / Q000628:therapy*; D014481:United States