Paramedic Drugs

Question 1

What are the indications for activated charcoal?

Answer 1

Emergency treatment of acute oral poisoning including drug overdose where:
- Toxin ingested < 1 hour ago
- Pt > 1 year old
OR
- Toxbase/National Poisons Agency has advised

Question 2

What type of poisoning is activated charcoal most commonly used for?

Answer 2

Paracetamol overdose

Question 3

What are the contraindications of activated charcoal?

Answer 3

-Vomiting
-Reduced GI motility (Risk of obstruction) e.g. pt on opiods/recent abdominal surgery
-Poison caused by:
-Cyanide
-Petroleum
-Metal salts including iron + lithium
-Ethanol/methanol/ethylene glycol
-Malathon
-Corrosive substances e.g. bleach

Question 4

What are the contraindications of activated charcoal?

Answer 4

-Vomiting
-Reduced GI motility (Risk of obstruction) e.g. pt on opiods/recent abdominal surgery
-Poison caused by:
-Cyanide
-Petroleum
-Metal salts including iron + lithium
-Ethanol/methanol/ethylene glycol
-Malathon
-Corrosive substances e.g. bleach

Question 5

What are the cautions/side effects of activated charcoal?

Answer 5

Aspiration (paeds)
Reduced effect of other antidotes
Difficulty swallowing (including intoxicated patients)
Bowel obstruction/perforation can occur (rare)