Abstract
Pediatric poisoning is a problem commonly encountered in the emergency department. After stabilization of airway, breathing, and circulation, one of the goals of treatment is decontamination in order to limit poison absorption and the resulting systemic toxicity. Decontamination modalities include gastric emptying (ipecac and gastric lavage), inhibiting absorption (activated charcoal), and catharsis (sorbital, magnesium citrate, and whole bowel irrigation). Each modality is discussed. Choice of modality by the practitioner must be individualized to each patient’s situation.
Similar content being viewed by others
References
Litovitz TL, Felberg I, Soloway RA, Ford M, Geller R. Nineteen Ninety Four Annual Report of the American Association of Poison Control Centers’ Toxic Exposure Surveillance systems.Am J Emerg Med. 1995; 13: 551–587.
Emergency Medicine 3rd ed, Ed J. Tintinalli, MD McGraw-Hill, Inc; 548.
Magic and Medicine of Plants, Edn. Dobilis Readers Digest General Books. 1986; 374–5.
Litovitz TL, Klein-Schwartz W, Odera GM, Matyunas NJ, Wiley S, Gorman RL. Ipecac administration in children younger than 1 year of age.Pediatrics 1985; 76: 761–764.
Robertson WO. Syrup of Ipecac-a slow or fast emetic?Am J Dis Child, 1962; 103: 58–61.
Bond GR. Home use of syrup of ipecac is associated with a reduction in pediatric emergency department visits.Ann Emerg Med 1993; 232 (9): 1403–7.
Bond GR, Requa RK, Krenzelok EP, Normann SA, Tendier JR, Morris CL, McCoy DJ, Thompson MW, McCarthy T, Toblez Jet al. Influence of time until emesis on the efficacy of decontamination using acetaminophen as a marker in a pediatric population.Ann Emerg Med 1993; 22 (9): 1403–7.
Gaudreault P, McCormck M, Lacouture Pet al. Poisoning exposures and use of ipecac in children less than 1 year old.Ann Emerg Med 1986; 15: 808–810.
Tandberg D, Liechty E, Fishbein, D. Mallory-Weiss syndrome: An unusual complication of ipecac-induced emesis.Ann Emerg Med 1981; 10 : 521–523.
Auerback P, Osterloh J, Braunet al. Efficacy of gastric emptying; Gastric lavage versus emesis induced with ipeace.Ann Emerg Med 1986; 15: 692–698.
McDougal C, MacLean M. Modifications in the technique of gastric lavage.Ann Emerg Med 1981; 10: 514–517.
Kulig K, Bar-Or D, Cantril SV. Rosen P, Rumack BH. Management of acutely poisoned patients without gastric emptying.Ann Emerg Med 1985; 14: 562–567.
Albertson TEet al. Superiority of Activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions.Ann Emerg Med 1989; 18(1): 56–59.
Merrigian KS, Woodsard M, Hedges JR, Roberts JR, Struebing R, Rashkin MC. Prospective evaluation of gastric emptying in the self-poisoned patient.Am J Emerg Med 1990; 8: 479–483.
Pond Set al. Gastric Emptying in Acute Overdose: A Prospective Randomized Controlled Trial.Med J Austral 1995; 162 : 345–349.
Eisen Tel al. The absorption of salicylates by a milk chocolate - charcoal mixture.Ann Emerg Med 1991; 20 (2): 143–146.
Krenzelok EP. Gastrointest transit times of carthartics used with activated charcoal and ipecac syrup in prevention.Clin Pharm 1985; 4: 446–448.
Bryson P. Comprehensive Review in Toxicology, Raven Press NY 1989; 17–25.
Sue YJ, Woolf A, Shannon M. Efficacy of magnesium citrate carthartic in pediatric toxic ingestions.Ann Emerg Med 1994; 24: 709–712.
Kirshenbaum LA, Matthews SC, Sitar DS, Tenebein M. Whole-bowel irrigation versus activated charcoal in sorbitol for the ingestion of modified release pharmaceuticals.Clin Pharmacol Ther 1989; 46: 264–271.
Tenebein M, Cohen S, Sitar DS. Whole bowel irrigation as a decontamination procedure after acute drug overdose.Arch Intern Med 1987; 147: 905–907.
Farley TA. Severe hypernatermic dehydration after use of an activated charcoalsorbitol suspension.J Pediatr 1986; 109: 719–722.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Walton, P.J., Fraser, J.J. & Wilhelm, G.W. Gastrointestinal decontamination in the emergency department. Indian J Pediatr 64, 451–455 (1997). https://doi.org/10.1007/BF02737747
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF02737747