Allison T B, Gough J E, Brown L H, Thomas S H
Department of Emergency Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354, USA.
Prehosp Emerg Care. 1997 Apr-Jun;1(2):73-5. doi: 10.1080/10903129708958791.
Activated charcoal (AC) has been proven useful in many toxic ingestions. Theoretically, administration of AC in the prehospital environment could save valuable time in the treatment of patients who have sustained potentially toxic oral ingestions. The purpose of this study was to determine the frequency of prehospital AC administration and to identify time savings that could potentially result from field AC administration.
Adult patients with a chief complaint of toxic ingestion who had complete emergency medical services (EMS) and emergency department (ED) records and no medical treatment (gastric emptying, AC administration) prior to EMS arrival were eligible for inclusion. Data obtained from EMS and ED records included time of EMS departure from the scene, time of EMS arrival at the ED, and time of administration of AC in the ED. Since most EMS agencies in this system do not insert gastric tubes, patients requiring gastric tube placement for administration of AC were excluded.
Twenty-nine of 117 (24.8%) adult patients received oral AC with no other intervention. None of the 117 patients received AC in the prehospital setting. The EMS transport time for these patients ranged from 5 to 43 minutes (mean 16.2 +/- 9.7 minutes). The delay from ED arrival to AC administration ranged from 5 to 94 minutes (mean 48.8 +/- 24.1 minutes), and was more than 60 minutes for 14 (48.2%) of the patients. The total time interval from scene departure to ED AC administration ranged from 17 to 111 minutes (mean 65.0 +/- 25.9 minutes).
In a selected subset of patients who tolerate oral AC, prehospital administration of AC could result in earlier and potentially more efficacious AC therapy. Prospective study of the benefits and feasibility of prehospital AC administration is indicated.
活性炭（AC）已被证明在许多中毒摄入情况中有用。理论上，在院前环境中给予AC可在治疗经口摄入潜在毒物的患者时节省宝贵时间。本研究的目的是确定院前给予AC的频率，并确定现场给予AC可能节省的时间。
以中毒摄入为主诉的成年患者，若有完整的紧急医疗服务（EMS）和急诊科（ED）记录，且在EMS到达之前未接受过医疗治疗（洗胃、给予AC），则符合纳入标准。从EMS和ED记录中获取的数据包括EMS离开现场的时间、EMS到达ED的时间以及在ED给予AC的时间。由于该系统中的大多数EMS机构不插入胃管，因此需要通过胃管给予AC的患者被排除。
117例成年患者中有29例（24.8%）接受了口服AC，未进行其他干预。117例患者中无一例在院前环境中接受AC。这些患者的EMS转运时间为5至43分钟（平均16.2±9.7分钟）。从ED到达至给予AC的延迟时间为5至94分钟（平均48.8±24.1分钟），14例（48.2%）患者的延迟时间超过60分钟。从离开现场至在ED给予AC的总时间间隔为17至111分钟（平均65.0±25.9分钟）。
在选定的能耐受口服AC的患者亚组中，院前给予AC可使AC治疗更早进行且可能更有效。有必要对院前给予AC的益处和可行性进行前瞻性研究。
