GASTRIC LAVAGE, EMESIS, AND ACTIVATED CHARCOAL: ARE THEY EFFECTIVE AS ROUTINE MANAGEMENTENT OF POISONED CHILDREN?

Key words: Poisoning, Gut decontamination, Gastric lavage, Emesis, Activated charcoal

Gastric lavage and emesis have been employed widely in gut decontamination of poisoned patients, but these procedures lack clear demonstration of clinical benefit, at least as a routine treatment. Moreover, complications and contraindications of these measures are well documented: laryngospasm, mechanical injury to the gut, oesophageal perforation and gastric haemorrhage, aspiration pnenumonia in comatose patients, particulary if hydrocarbons were ingested, hypernatraemia and water intoxication particulary in children. Cathartics as well have not shown to reduce significantly drugs and toxics agents with a few exceptions (acids, alkalis, ethanol, methanol, ethylene glycol, iron and lithium). Comparative studies have indicated that activated charcoal is better that either gastric lavage or syrup of hipecacuana in reducing drug absorption. If no lifethreatening symptoms are present, the first measure to be taken is calling an poison centre for appropriate advice.