activated charcoal
What did they do?
The Clinical Toxicology Recommendations Collaborative (CTRC - group of 3 international tox societies) made official recommendations/guidelines on the use of activated charcoal (AC) for ingestions.
Relevance?
They looked at the data and are now recommending prolonged window, >1hr for AC administration for certain ingestions (eg. Acetaminophen, salicylates, antihistamines, and calcium channel blockers). They also recommend repeated doses of AC based on the ingested amount. This chart basically summarizes it.
The Clinical Toxicology Recommendations Collaborative (CTRC - group of 3 international tox societies) made official recommendations/guidelines on the use of activated charcoal (AC) for ingestions.
Relevance?
They looked at the data and are now recommending prolonged window, >1hr for AC administration for certain ingestions (eg. Acetaminophen, salicylates, antihistamines, and calcium channel blockers). They also recommend repeated doses of AC based on the ingested amount. This chart basically summarizes it.
The Bottom Line:
Activated charcoal is still recommended during the first hour after ingestion for a lot of poisons and has shown a benefit. In some cases you might be asked to give AC later that 1 hour post ingestion, and give more than one dose of AC. Most of us are probably going to be giving AC per the tox centers recommendations, so don’t be surprised if they recommend giving it up to 6 hours post ingestion or a couple of doses for high dose ingestions. There are strong recommendations to give AC for acetaminophen and salicylate ingestions >200mg/kg at up to 2 hours post ingestion, so you might want to get that AC started before waiting to get ahold of the poison center. Here is a helpful algorithm for when to give AC.
Activated charcoal is still recommended during the first hour after ingestion for a lot of poisons and has shown a benefit. In some cases you might be asked to give AC later that 1 hour post ingestion, and give more than one dose of AC. Most of us are probably going to be giving AC per the tox centers recommendations, so don’t be surprised if they recommend giving it up to 6 hours post ingestion or a couple of doses for high dose ingestions. There are strong recommendations to give AC for acetaminophen and salicylate ingestions >200mg/kg at up to 2 hours post ingestion, so you might want to get that AC started before waiting to get ahold of the poison center. Here is a helpful algorithm for when to give AC.
