Spiller H A, Rodgers G C
Kentucky Regional Poison Center, Louisville, Kentucky 40232-5070, USA.
Pediatrics. 2001 Dec;108(6):E100. doi: 10.1542/peds.108.6.e100.
Activated charcoal (AC) is recognized as the treatment of choice for gastrointestinal decontamination after many ingestions. AC use in the home has been limited by concerns that parents would not administer it properly and that children would refuse to take AC. Previous descriptions of home administration have reported mixed results.
This was an 18-month consecutive case series of all patients for whom AC administration was recommended in the home. Data collected included AC availability in the home and/or a local pharmacy, success in administration, amount administered, time after ingestion to AC administration, difficulties in administration, adverse effects, age and gender of patient, substance involved in poisoning, and medical outcome. All cases were followed for at least 3 days after the ingestion. Patients who initially had home AC recommendation but who ultimately were treated in the emergency department (ED) served as a comparison group.
Home administration of AC was recommended in 138 cases. A total of 115 individuals (83%) were treated with AC in the home, with no failures to administer AC. Reasons for failure to manage at home were 1) mother preferred ED (8 cases), 2) could not locate AC (7 cases), 3) pharmacy closed for the night (6 cases) and 4) no home telephone for follow-up (2 cases). Time to AC administration after ingestion was a mean of 38 minutes (+/-18.3) for home treatment and 73 minutes (+/-18.1) for ED treatment. Ninety-five percent of home cases received AC in < or =60 minutes versus 33% for ED management. AC was in the home in 11 cases at the time of recommendation. The amount of AC administered was a mean of 12.1 g (standard deviation: 6.9) and a median of 12 g. Eight children (6.9%) who were treated at home vomited after AC versus 3 (13%) who received ED treatment. No aspirations or complications occurred.
AC can be administered successfully by the lay public in the home. Home use of AC significantly reduces the time to AC administration.
活性炭（AC）被公认为是多种摄入物后胃肠道去污的首选治疗方法。家庭中使用AC受到限制，原因是担心父母不能正确给药以及儿童会拒绝服用AC。先前关于家庭给药的描述报告的结果不一。
这是一个为期18个月的连续病例系列，涵盖所有在家中被建议使用AC的患者。收集的数据包括家中和/或当地药房是否有AC、给药成功情况、给药量、摄入后至给予AC的时间、给药困难、不良反应、患者年龄和性别、中毒涉及的物质以及医疗结果。所有病例在摄入后至少随访3天。最初被建议在家中使用AC但最终在急诊科（ED）接受治疗的患者作为对照组。
138例患者被建议在家中使用AC。共有115人（83%）在家中接受了AC治疗，AC给药无一失败。未能在家中处理的原因有：1）母亲倾向于去急诊科（8例），2）找不到AC（7例），3）药房夜间关门（6例），4）没有家庭电话用于随访（2例）。摄入后至给予AC的时间，在家中治疗平均为38分钟（±18.3），在急诊科治疗平均为73分钟（±18.1）。95%的在家治疗病例在≤60分钟内接受了AC，而在急诊科治疗的这一比例为33%。建议时，11例家中有AC。给予AC的量平均为12.1克（标准差：6.9），中位数为12克。在家中接受治疗的8名儿童（6.9%）在服用AC后呕吐，而在急诊科接受治疗的有3名（13%）。未发生误吸或并发症。
非专业人员可在家中成功给予AC。在家中使用AC可显著缩短给予AC的时间。
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