Skip Navigation



QJM Advance Access published online on July 22, 2005
QJM, doi:10.1093/qjmed/hci102
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
98/9/655    most recent
hci102v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Cooper, G.M.
Right arrow Articles by Buckley, N.A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cooper, G.M.
Right arrow Articles by Buckley, N.A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received November 23, 2004
Revised June 23, 2005

Original paper

A randomized clinical trial of activated charcoal for the routine management of oral drug overdose

G.M. Cooper 1*, D.G. Le Couteur 2, D. Richardson 3, and N.A. Buckley 4

1 From the Pharmacy, University of Canberra, Bruce, Australia
2 From the Centre for Education and Research on Ageing and ANZAC Research Institute, University of Sydney, Concord Repatriation General Hospital, Concord, Australia
3 From the Department of Emergency Medicine, Canberra Clinical School, The Canberra Hospital, Canberra, Australia
4 From the Department of Clinical Pharmacology and Toxicology, Canberra Clinical School, The Canberra Hospital, Canberra, Australia

* To whom correspondence should be addressed.
G.M. Cooper, E-mail: gabrielle.cooper{at}canberra.edu.au


  Abstract

Background: Activated charcoal (AC) is commonly used for the routine management of oral drug overdose.

Aim: To determine whether the routine use of activated charcoal has an effect on patient outcomes.

Design: Randomized controlled unblinded trial.

Methods: We recruited all adult patients presenting with an oral overdose at The Canberra Hospital, excluding only transfers, late presenters, those who had ingested drugs not adsorbed by activated charcoal or where administration was contraindicated, and very serious ingestions (at the discretion of the admitting physician). Patients were randomized to either activated charcoal or no decontamination.

Results: The trial recruited 327 patients over 16 months. Of 411 presentations, four refused consent, 27 were protocol violations and 53 were excluded from the trial. Only seven were excluded due to the severity of their ingestion. The most common substances ingested were benzodiazepines, paracetamol and selective serotonin reuptake inhibitor antidepressants. More than 80% of patients presented within 4 h following ingestion. There were no differences between AC and no decontamination in terms of length of stay (AC 6.75 h, IQR 4-14 vs. controls 5.5 h, IQR 3-12; p = 0.11) or secondary outcomes including vomiting, mortality and intensive care admission.

Discussion: Routine administration of charcoal following oral overdose did not significantly influence length of stay or other patient outcomes following oral drug overdose. There were few adverse events. This does not exclude a role in patients who present shortly after ingestion of highly lethal drugs.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 BMJHome page
Minerva
BMJ, December 17, 2005; 331(7530): E398 - E398.
[Full Text] [PDF]

Home page
 BMJHome page
Minerva
BMJ, September 10, 2005; 331(7516): 584 - 584.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.