Print

Print


My clothes have also been unduly colored by the use of activated
charcoal.  I agree with you--we should refrain from using AC in cases
where it is of questionable benefit. I, too, have had the experience of
trying to intubate a patient who was vomiting charcoal--visualization is,
at best, difficult.
 
Our regional poison control center continues to recommend AC for
alcohols, despite the facts that is fairly ineffective and absorption is
complete by the time the p[atient arrives in the ED. Many kids with
alcohol ingestion vomit, so it seems like a perfect setup for a bad
outcome...
 
 
Jim Chamberlain
Emergency Department
Children's Hospital
111 Michigan Ave, NW
Washington, DC 20010
(202) 884-3253 OFC
(202) 884-3573 FAX
[log in to unmask]
 
On Fri, 30 Jun 1995, ALICE ACKERMAN wrote:
 
> The recent anaphylaxis discussion has opened up the opportunity I've
> been looking for to comment on the use of charcoal, as an "inert"
> (easily translated into "benign") substance.  Charcoal has many
> defined uses, and I freely give it in children who have ingested a
> toxin for which it has proven beneficial.  I am, however, decidedly
> against its use (especially repeated doses) in less clear
> circumstances.
>
> As a pediatric intensivist, I have observed a number of circumstances
> in which a child has vomited the charcoal and suffered from
> aspiration (one of whom died).  If the administration of charcoal
> eliminates the risk of the 2nd phase of anaphylaxis, it might be
> worth giving, otherwise, the presence of charcoal in the stomach of
> someone with a 20% chance of developing airway obstruction is not my
> idea of a fun time.  Presumably the child will respond well to our
> medical management of the recurrent anaphylaxis, if it occurs, but
> what if he doesn't?
>
> I am very interested in the opinions of the participants on this list
> regarding the use of charcoal in"unproven" circumstances.  Is there
> any one out there who shares my dislike for charcoal, or has my
> opinion been unduely colored by my unfortunate experiences?
> Alice D. Ackerman, M.D.
> University of Maryland Medical System
> (410) 328-6957 (phone)
> (410)328-0680 (fax)
> [log in to unmask]
>