Gastrointestinal decontamination in paediatric exploratory ingestions

N Z Med J. 2002 Jun 7;115(1155):260-2.

Abstract

Aim: To review the effect of treatment changes in paediatric exploratory ingestion at Christchurch Hospital.

Methods: We carried out a retrospective review of paediatric patients presenting with potentially toxic ingestion during six month periods of 1994, 1996 and 1999.

Results: All three groups were comparable in respect to age and gender. There were minor changes in the range and proportion of substances ingested - with those in the 1999 group more likely to have taken paracetamol. In 1994, 36% of children were treated with syrup of ipecac. By 1996, only 9% were given ipecac, with 49% treated with activated charcoal. By 1999, 12% were treated with activated charcoal, while 88% received no decontamination. There was a lower admission rate in the 1999 group with no overall change in outcome.

Conclusions: It is rare for paediatric exploratory ingestions to result in significant toxicity. Gastrointestinal decontamination should not be routinely used in these patients as the risk of the procedure may outweigh the risk of the poison exposure.

MeSH terms

  • Acetaminophen / poisoning*
  • Charcoal / therapeutic use
  • Child, Preschool
  • Decontamination / methods
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Ipecac / therapeutic use
  • Male
  • Medical Records
  • New Zealand / epidemiology
  • Outcome Assessment, Health Care*
  • Plant Poisoning / epidemiology
  • Plant Poisoning / therapy
  • Poisoning / epidemiology
  • Poisoning / therapy
  • Retrospective Studies

Substances

  • Charcoal
  • Acetaminophen
  • Ipecac