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Poisoning: are current treatments best?

Poisoning: are current treatments best?

Friday 22 July 2005

Over the years, poisoning has been variously treated by attempting to bring the poison back up, rushing it through the body, or binding it in the gut so that it doesn't spread to other body parts.

And relatively recently, treatments such as syrup of ipecac, orogastric tubes, and activated charcoal have been largely discarded.

Activated charcoal is still used, however, for potentially serious poisoning if the patient is treated within an hour of ingestion.

At the Winter Symposium of the Australasian College for Emergency Medicine being held at the Millennium Hotel in Queenstown NZ, Professor Mike Ardagh, Professor of Emergency Medicine at Christchurch School of Medicine and Health Sciences, will canvass whether the current treatment of poisoning is in fact the best.

He will speak on Friday July 22 at 9.00 - 9.30.

"Our current enlightenment is based on evidence published in medical journals and our practice, therefore, is in keeping with the profession's enthusiasm for evidence-based medicine, EBM.

"Perhaps though, our practice is really EBI - evidence-based ignorance - or EBE - evidence-based error.

"The published clinical trials have been unable to show any difference in outcome when comparing patients who get gastric emptying in addition to activated charcoal, with those who get activated charcoal alone.

"Almost all poisoned patients who don't die make a full recovery.

"So outcomes, almost invariably, are full recovery or death."

Professor Ardagh said less that 1% of patients who come to an ED with poisoning have death as an outcome.

He said the usefulness of activated charcoal in the prevention of death is unknown.

At the conference he will offer suggestions on the role of gastrointestinal decontamination in the management of poisoned patients.


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