Activated charcoal Flashcards
What it is
A plastic bottle containing 50g of activated charcoal granules, it must be mixed with a liquid usually water or cordial/juice for taste to create an ingestible solution.
Classifications
Antidotes and chelators, it is an intestinal absorbent, it reduces the absorption of poisons in the gastrointestinal system, it preforms an active elimination of poisons
What is it used for
It is commonly referred to as an ‘antidote’ as it’s main purpose is to act against poisons
Once the solution of 50g of granules and liquid has been made up, this mixture now acts as a sponge and absorbs certain toxins within the gastrointestinal system (Ines that are digested) this can include, certain medications drugs, and poisons as they are all digested.
Its main use it to treat overdoses and poisons
How do you take it
It is administered PO (orally), the patient should drink as much of the mixture as the can manage. it is known for its bad taste and therefore certain patients have trouble ingesting it
When to give it
It is give as an emergency treatment for acute oral poisoning or drug overdose
Activated charcoal is self-administered, due to this the patient MUST present as A on the AVPU scale. A patient who presents as V on the AVPU scale may be administered activated charcoal but only in situations when the patients can swallow safely and maintain their airway and there is no reduction in gag reflex, the patient should be monitored very closely and AC should be administered at clinical judgment
The patient must be alert and able to swallow safely, the EMT should ensure hat the patient can maintain their airway and doe snot have a reduced gag reflex
Contra-indications
Activated charcoal will work for a large number of toxins and drugs but not all of them, even though there are some that they do not work for it will not cause any further damage by administering the drug in that situation but it will be ineffective to the patient’s situation ie it won make t worse but it won’t make it better
Activated charcoal does not work well for iron salts, cyanide, and certain solvents which include methanol, ethanol, ethylene glycol
It will not work for alcohol overdose or alcohol in general
Dosages
Activated charcoal is given to adults/patients aged 18 and over
it is not indicated for paediatrics due to risk of choking and aspiration
(Activated charcoal CAN be given to children aged 1-17 as children tend to have the highest rates if overdose due to them ingesting everything out of curiosity and accident, but it is not indicated on the CPGs for an EMT to administer it to anyone under the age of 18 so keep in mind for exams)
The general dosage is 50g for adults (1g per kg in a child) of activated charcoal granules that have been reconstituted using water or juice for taste, the patient is encouraged to ingest as much of it as they can or as much as of it as needed
do not give more than the 50g dose due to an aspiration risk, risk of constipation, bowel issues and gastrointestinal discomfort, blockages and vomiting, overuse can also cause an electrolyte imbalance
Typical side effects
Bezoar (a build up mass of undigested material that becomes trapped in the stomach or intestines)
Constipation ( activated charcoal is designed to bind to toxins and liquids in the small intestines (where most liquid is absorbed into the body) it may cause the small intestine to become dehydrated)
Diarrhoea (Activated charcoal can sometimes stimulate the digestive system to move more quickly, as it binds to toxins it may also bind to and absorb certain bacteria in the digestive system causing an imbalance and irritation, the patient may also have underlying medical conditions such as IBS or IBD)
GI disorders
Black stools
What activated charcoal absorbs
Aspirin and salicylates
barbiturates
Benzodiazepines
Chlormethiazole
Chloroquine
Chlorpromazine & related phenothiazines
Clonidine
Cocaine and other stimulants
Digoxin and digitoxin
Ibuprofen
Menfenamic acid
Mianserin
Nicotine
Paracetamol
Paraquat
Phenelzine and other MAOIs
Phenytoin
Propranolol and other beta blockers
Quinine
Theophylline
Zidovudine
