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J Accid Emerg Med. 1999 March; 16(2): 84–86.
PMCID: PMC1343284

Gastric decontamination--a view for the millennium.


The management of acute poisoning remains an important part of accident and emergency (A&E) care. Three gastric decontamination procedures have been widely used: gastric lavage, ipecac, and activated charcoal. Their role has recently been reviewed and position statements developed by working groups of the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. These have important implications for A&E, as they indicate that activated charcoal is now the agent of choice for most poisons, but than in most situations it is probably only effective if given within an hour of overdose. Ipecac is effectively obsolete and gastric lavage has a narrow range of indications, principally for potentially serious amounts of agents not adsorbed by charcoal. Protocols for care of overdose patients should be modified accordingly.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Thompson AM, Robins JB, Prescott LF. Changes in cardiorespiratory function during gastric lavage for drug overdose. Hum Toxicol. 1987 May;6(3):215–218. [PubMed]
  • Blake DR, Bramble MG. Is there excessive use of gastric lavage in the treatment of self-poisoning? Lancet. 1978 Dec 23;2(8104-5):1362–1364. [PubMed]
  • Corby DG, Decker WJ, Moran MJ, Payne CE. Clinical comparison of pharmacologic emetics in children. Pediatrics. 1968 Aug;42(2):361–364. [PubMed]
  • Auerbach PS, Osterloh J, Braun O, Hu P, Geehr EC, Kizer KW, McKinney H. Efficacy of gastric emptying: gastric lavage versus emesis induced with ipecac. Ann Emerg Med. 1986 Jun;15(6):692–698. [PubMed]
  • Pond SM, Lewis-Driver DJ, Williams GM, Green AC, Stevenson NW. Gastric emptying in acute overdose: a prospective randomised controlled trial. Med J Aust. 1995 Oct 2;163(7):345–349. [PubMed]

Articles from Journal of Accident & Emergency Medicine are provided here courtesy of BMJ Group