Activated Charcoal (cont.)
How Activated Charcoal Is Given
Activated charcoal may be given by mouth to someone who is awake and alert. It is a black liquid drink.
- If the person vomits the drink, another dose will be given through a nasogastric or orogastric tube (a tube inserted through the nose or mouth, down the esophagus and into the stomach).
- If the person is unconscious (or nearly so), an endotracheal intubation (a procedure in which a tube is inserted through the mouth down into the trachea) may be necessary. This allows oxygen to be delivered and helps protect the airway and lungs from gastric content, which minimizes the risk of the person vomiting and choking.
- Activated charcoal is usually given by a doctor. It is not a substance to be used at home. Doctors determine the dose or amount of charcoal to give based on the patient's weight (with special doses for children) and on how much poison was swallowed. There are some doctors who will prescribe charcoal for emergency use in the home. This should only be done under the direct guidance of the doctor or poison control center. In the United States, the direct line to the poison control center is 1-800-222-1222.
- The doctor also determines when and if additional doses are given by monitoring blood levels of the poison. Other symptoms the doctor monitors are nausea and vomiting, abdominal pain, dizziness, and severe heart problems. Multiple doses of activated charcoal can be given if someone swallowed large doses of long-acting, sustained release medications.
- In some cases, if blood levels of the poison remain too high, the doctor may recommend kidney dialysis. Dialysis may be the best way to remove the toxin from the bloodstream.
When Not to Use Activated Charcoal
- Activated charcoal will not be given to people with an obstruction of the intestines or if the person swallowed a corrosive agent, such as a strong acid or alkali.
- Strong acids may "burn" through the lining of the GI tract. Doctors will need to look at the lining with an endoscope - a special instrument designed to look inside the stomach. Activated charcoal is not to be used with this type of poison because it is difficult to see the lining of the GI tract with the scope after charcoal is given.
- Activated charcoal can cause intestinal problems such as constipation, or it can create clumps of foreign material. This situation can be prevented by giving a laxative such as sorbitol to the patient, however, repeated doses with sorbitol may cause excessive diarrhea, dehydration, and chemical imbalance.
- If the patient is fructose intolerant, family members should notify the treating doctor, and sorbitol will not be given with the activated charcoal. Sorbitol is a sugar substitute that acts as a laxative to move the charcoal through the system. Infants younger than one year of age year should not be given sorbitol because it may cause excessive fluid losses.
- If an antidote to a specific type of drug poisoning is given, then the doctor may not give activated charcoal because the drug given as treatment will also be adsorbed. A classic example is an acetaminophen (Tylenol overdose) in which there is a clearly established antidote with acetylcysteine (Mucomyst).
Medically Reviewed by a Doctor on 9/30/2016
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