Evaluation of the effects of multiple-dose activated charcoal on the absorption of orally administered salicylate in a simulated toxic ingestion model

Barone, Joseph A.; Raia, John J.; Huang, Yih C.

doi:10.1016/s0196-0644(88)80500-6

Cited by 40 publications

(13 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 9 A study in adult volunteers given 1.9 g of aspirin showed that three, four hourly 50 g doses of charcoal resulted in a significant decrease in salicylate absorption when compared with one or two doses of charcoal. 10 Aspirin forms concretions within the stomach 11 12 and it may be important to recoat surfaces of such concretions with charcoal to reduce ongoing absorption. The administration of a second dose of activated charcoal is of particular value in adults who have ingested substantial quantities of an enteric coated or sustained release preparation.…”

Section: Prevention Of Further Absorptionmentioning

confidence: 99%

An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose

Dargan

2002

Emergency Medicine Journal

View full text Add to dashboard Cite

Objective: To develop a flowchart to be used as a tool to guide clinicians step by step through the management of salicylate poisoning. Methods: A comprehensive literature search was carried out. Results: The evidence base was used to develop a management flowchart that guides the clinician through the three main steps in caring for the patient with salicylate poisoning: preventing further absorption, assessing the severity of poisoning and, where appropriate, increasing elimination. Conclusions: Salicylate poisoning can result in severe morbidity and mortality and this flowchart provides an evidence based guideline that will guide clinicians through the management of patients presenting to the emergency department with salicylate poisoning.

show abstract

Section: Prevention Of Further Absorptionmentioning

confidence: 99%

An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose

Dargan

2002

Emergency Medicine Journal

View full text Add to dashboard Cite

show abstract

“…Activated charcoal, single-dose There were 13 clinical trials (level 1b) that examined the effect of activated charcoal on aspirin absorption (193)(194)(195)(196)(197)(198)(199)(200)(201)(202)(203)(204)(205). None of these studies was performed as out-of-hospital care.…”

Section: Treatment Measuresmentioning

confidence: 99%

Salicylate poisoning: An evidence-based consensus guideline for out-of-hospital management

Chyka

Erdman

Christianson

et al. 2007

Clinical Toxicology

115

View full text Add to dashboard Cite

American Association of Poison Control Centers, Washington, District of Columbia, USAA review of U.S. poison center data for 2004 showed over 40,000 exposures to salicylate-containing products. A guideline that determines the conditions for emergency department referral and pre-hospital care could potentially optimize patient outcome, avoid unnecessary emergency department visits, reduce health care costs, and reduce life disruption for patients and caregivers. An evidence-based expert consensus process was used to create the guideline. Relevant articles were abstracted by a trained physician researcher. The first draft of the guideline was created by the lead author. The entire panel discussed and refined the guideline before distribution to secondary reviewers for comment. The panel then made changes based on the secondary review comments. The objective of this guideline is to assist poison center personnel in the appropriate out-of-hospital triage and initial out-of-hospital management of patients with a suspected exposure to salicylates by 1) describing the process by which a specialist in poison information should evaluate an exposure to salicylates, 2) identifying the key decision elements in managing cases of salicylate exposure, 3) providing clear and practical recommendations that reflect the current state of knowledge, and 4) identifying needs for research. This guideline is based on an assessment of current scientific and clinical information. The expert consensus panel recognizes that specific patient care decisions may be at variance with this guideline and are the prerogative of the patient and the health professionals providing care, considering all of the circumstances involved. This guideline does not substitute for clinical judgment. Recommendations are in chronological order of likely clinical use. The grade of recommendation is in parentheses: 1) Patients with stated or suspected self-harm or who are the victims of a potentially malicious administration of a salicylate, should be referred to an emergency department immediately. This referral should be guided by local poison center procedures. In general, this should occur regardless of the dose reported (Grade D).2) The presence of typical symptoms of salicylate toxicity such as hematemesis, tachypnea, hyperpnea, dyspnea, tinnitus, deafness, lethargy, seizures, unexplained lethargy, or confusion warrants referral to an emergency department for evaluation (Grade C). 3) Patients who exhibit typical symptoms of salicylate toxicity or nonspecific symptoms such as unexplained lethargy, confusion, or dyspnea, which could indicate the development of chronic salicylate toxicity, should be referred to an emergency department (Grade C). 4) Patients without evidence of self-harm should have further evaluation, including determination of the dose, time of ingestion, presence of symptoms, history of other medical conditions, and the presence of co-ingestants. The acute ingestion of more than 150 mg/kg or 6.5 g of aspirin equivalent, whichever is less, war...

show abstract

“…Multiple-dose activated charcoal seems to increase the elimination of salicylates compared with single-dose activated charcoal, although animal and human data have been conflicting [138][139][140][141]. The current American Academy of Clinical Toxicology/European Association of Poison Control Centers and Toxicologists position statement has concluded that insufficient evidence exists to recommend multiple-dose activated charcoal [141].…”

Section: Managementmentioning

confidence: 99%

Deadly pediatric poisons: nine common agents that kill at low doses

Michael

Sztajnkrycer

2004

Emergency Medicine Clinics of North America

View full text Add to dashboard Cite

Evaluation of the effects of multiple-dose activated charcoal on the absorption of orally administered salicylate in a simulated toxic ingestion model

Cited by 40 publications

References 16 publications

An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose

An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose

Salicylate poisoning: An evidence-based consensus guideline for out-of-hospital management

Deadly pediatric poisons: nine common agents that kill at low doses

Contact Info

Product

Resources

About