Assessment of the efficacy of activated charcoal following gastric lavage in acute drug emergencies.

The efficacy of administering a slurry of 100 g of activated charcoal (AC) via the gastric tube following lavage was assessed in 25 treated and 37 control patients presenting to the emergency room with chemical evidence of sedative-hypnotics or aspirin in the blood. Efficacy was evaluated as the ability of AC to prevent further absorption as determined by subsequent blood drug concentration changes. Although fewer patients in the AC group showed increased blood drug concentrations, the differences were not statistically significant. Comparison of the mean percent change in blood drug concentrations at various times following treatment produced similar results. Comparisons using subgroups of patients based on the individual drugs, the treatment delay time, and entering functional decompensation showed significant benefit from AC only in the less symptomatic patients. Comparing these results with other studies demonstrating the unequivocal efficacy of early (e.g., 30 min) treatment, it is concluded that the use of AC following lavage may often be too late to benefit most patients. The authors suggest that AC be given in the home, emergency vehicle, or immediately upon admission.