The frequency of complications associated with the use of multiple-dose activated charcoal

Catherine L. Dorrington, David W. Johnson, Rollin Brant, Randall Berlin, Mohamud Ramzan Daya, Roy Purssell, Michael Mullins, Sunita Vohra, Adam McOiarmid, Cathy Dorrington

Research output: Contribution to journalArticle

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Abstract

Study objective: The objective of this study was to determine the frequency of complications associated with the use of multiple-dose activated charcoal. Methods: The study population was drawn from 8 tertiary care hospitals in 4 North American cities. Medical records of all inpatients between March 1993 and March 1998 with a discharge diagnosis of poisoning (International Classification of Diseases, 9th edition, Clinical Modification codes 960-989.9) were reviewed to select patients who had received multiple-dose activated charcoal (defined as ≥2 doses administered within 12 hours). Medical records of patients who received multiple-dose activated charcoal were reviewed for patient demographics and clinical information regarding the occurrence of pulmonary aspiration, gastrointestinal obstruction, hypernatremia, hypermagnesemia, corneal abrasion, and other complications associated with the use of multiple-dose activated charcoal. Results: We reviewed 6,258 medical records, identifying 878 patients who received multiple-dose activated charcoal. We judged 5 (0.6%; 95% confidence interval [CI] 0.1% to 1.1%) patients to have had clinically significant pulmonary aspiration and none (0%; upper 95% CI 0.3%) to have had gastrointestinal obstruction. None of the patients with pulmonary aspiration died or had residual sequelae recorded. Hypernatremia (peak serum sodium >145 mEq/L [145 mmol/L]) was documented in 53 (6.0%; 95% CI 4.4% to 7.6%) patients, of whom 5 (0.6%; 95% CI 0.1% to 1.1%) had a serum sodium concentration of greater than 155 mEq/L (155 mmol/L). Hypermagnesemia (peak serum magnesium >2.5 mg/dL [1.0 mmol/L]) was documented in 27 (3.1%; 95% CI 2.0% to 4.2%) patients, of whom 3 (0.3%; 95% CI 0.1% to 1.0%) had peak values that were greater than 3.75 mg/dL (1.5 mmol/L). One patient had a corneal abrasion (0.1%; 95% CI 0% to 0.6%). No other complications were identified. Conclusion: Clinically significant complications associated with the use of multipledose activated charcoal occur infrequently.

Original languageEnglish (US)
Pages (from-to)370-377
Number of pages8
JournalAnnals of Emergency Medicine
Volume41
Issue number3
DOIs
StatePublished - Mar 1 2003
Externally publishedYes

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Charcoal
Confidence Intervals
Hypernatremia
Medical Records
Lung
Sodium
Serum
International Classification of Diseases
Tertiary Healthcare
Tertiary Care Centers
Poisoning
Magnesium
Inpatients
Demography

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Dorrington, C. L., Johnson, D. W., Brant, R., Berlin, R., Daya, M. R., Purssell, R., ... Dorrington, C. (2003). The frequency of complications associated with the use of multiple-dose activated charcoal. Annals of Emergency Medicine, 41(3), 370-377. https://doi.org/10.1067/mem.2003.86

The frequency of complications associated with the use of multiple-dose activated charcoal. / Dorrington, Catherine L.; Johnson, David W.; Brant, Rollin; Berlin, Randall; Daya, Mohamud Ramzan; Purssell, Roy; Mullins, Michael; Vohra, Sunita; McOiarmid, Adam; Dorrington, Cathy.

In: Annals of Emergency Medicine, Vol. 41, No. 3, 01.03.2003, p. 370-377.

Research output: Contribution to journalArticle

Dorrington, CL, Johnson, DW, Brant, R, Berlin, R, Daya, MR, Purssell, R, Mullins, M, Vohra, S, McOiarmid, A & Dorrington, C 2003, 'The frequency of complications associated with the use of multiple-dose activated charcoal', Annals of Emergency Medicine, vol. 41, no. 3, pp. 370-377. https://doi.org/10.1067/mem.2003.86
Dorrington, Catherine L. ; Johnson, David W. ; Brant, Rollin ; Berlin, Randall ; Daya, Mohamud Ramzan ; Purssell, Roy ; Mullins, Michael ; Vohra, Sunita ; McOiarmid, Adam ; Dorrington, Cathy. / The frequency of complications associated with the use of multiple-dose activated charcoal. In: Annals of Emergency Medicine. 2003 ; Vol. 41, No. 3. pp. 370-377.
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abstract = "Study objective: The objective of this study was to determine the frequency of complications associated with the use of multiple-dose activated charcoal. Methods: The study population was drawn from 8 tertiary care hospitals in 4 North American cities. Medical records of all inpatients between March 1993 and March 1998 with a discharge diagnosis of poisoning (International Classification of Diseases, 9th edition, Clinical Modification codes 960-989.9) were reviewed to select patients who had received multiple-dose activated charcoal (defined as ≥2 doses administered within 12 hours). Medical records of patients who received multiple-dose activated charcoal were reviewed for patient demographics and clinical information regarding the occurrence of pulmonary aspiration, gastrointestinal obstruction, hypernatremia, hypermagnesemia, corneal abrasion, and other complications associated with the use of multiple-dose activated charcoal. Results: We reviewed 6,258 medical records, identifying 878 patients who received multiple-dose activated charcoal. We judged 5 (0.6{\%}; 95{\%} confidence interval [CI] 0.1{\%} to 1.1{\%}) patients to have had clinically significant pulmonary aspiration and none (0{\%}; upper 95{\%} CI 0.3{\%}) to have had gastrointestinal obstruction. None of the patients with pulmonary aspiration died or had residual sequelae recorded. Hypernatremia (peak serum sodium >145 mEq/L [145 mmol/L]) was documented in 53 (6.0{\%}; 95{\%} CI 4.4{\%} to 7.6{\%}) patients, of whom 5 (0.6{\%}; 95{\%} CI 0.1{\%} to 1.1{\%}) had a serum sodium concentration of greater than 155 mEq/L (155 mmol/L). Hypermagnesemia (peak serum magnesium >2.5 mg/dL [1.0 mmol/L]) was documented in 27 (3.1{\%}; 95{\%} CI 2.0{\%} to 4.2{\%}) patients, of whom 3 (0.3{\%}; 95{\%} CI 0.1{\%} to 1.0{\%}) had peak values that were greater than 3.75 mg/dL (1.5 mmol/L). One patient had a corneal abrasion (0.1{\%}; 95{\%} CI 0{\%} to 0.6{\%}). No other complications were identified. Conclusion: Clinically significant complications associated with the use of multipledose activated charcoal occur infrequently.",
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AU - Johnson, David W.

AU - Brant, Rollin

AU - Berlin, Randall

AU - Daya, Mohamud Ramzan

AU - Purssell, Roy

AU - Mullins, Michael

AU - Vohra, Sunita

AU - McOiarmid, Adam

AU - Dorrington, Cathy

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N2 - Study objective: The objective of this study was to determine the frequency of complications associated with the use of multiple-dose activated charcoal. Methods: The study population was drawn from 8 tertiary care hospitals in 4 North American cities. Medical records of all inpatients between March 1993 and March 1998 with a discharge diagnosis of poisoning (International Classification of Diseases, 9th edition, Clinical Modification codes 960-989.9) were reviewed to select patients who had received multiple-dose activated charcoal (defined as ≥2 doses administered within 12 hours). Medical records of patients who received multiple-dose activated charcoal were reviewed for patient demographics and clinical information regarding the occurrence of pulmonary aspiration, gastrointestinal obstruction, hypernatremia, hypermagnesemia, corneal abrasion, and other complications associated with the use of multiple-dose activated charcoal. Results: We reviewed 6,258 medical records, identifying 878 patients who received multiple-dose activated charcoal. We judged 5 (0.6%; 95% confidence interval [CI] 0.1% to 1.1%) patients to have had clinically significant pulmonary aspiration and none (0%; upper 95% CI 0.3%) to have had gastrointestinal obstruction. None of the patients with pulmonary aspiration died or had residual sequelae recorded. Hypernatremia (peak serum sodium >145 mEq/L [145 mmol/L]) was documented in 53 (6.0%; 95% CI 4.4% to 7.6%) patients, of whom 5 (0.6%; 95% CI 0.1% to 1.1%) had a serum sodium concentration of greater than 155 mEq/L (155 mmol/L). Hypermagnesemia (peak serum magnesium >2.5 mg/dL [1.0 mmol/L]) was documented in 27 (3.1%; 95% CI 2.0% to 4.2%) patients, of whom 3 (0.3%; 95% CI 0.1% to 1.0%) had peak values that were greater than 3.75 mg/dL (1.5 mmol/L). One patient had a corneal abrasion (0.1%; 95% CI 0% to 0.6%). No other complications were identified. Conclusion: Clinically significant complications associated with the use of multipledose activated charcoal occur infrequently.

AB - Study objective: The objective of this study was to determine the frequency of complications associated with the use of multiple-dose activated charcoal. Methods: The study population was drawn from 8 tertiary care hospitals in 4 North American cities. Medical records of all inpatients between March 1993 and March 1998 with a discharge diagnosis of poisoning (International Classification of Diseases, 9th edition, Clinical Modification codes 960-989.9) were reviewed to select patients who had received multiple-dose activated charcoal (defined as ≥2 doses administered within 12 hours). Medical records of patients who received multiple-dose activated charcoal were reviewed for patient demographics and clinical information regarding the occurrence of pulmonary aspiration, gastrointestinal obstruction, hypernatremia, hypermagnesemia, corneal abrasion, and other complications associated with the use of multiple-dose activated charcoal. Results: We reviewed 6,258 medical records, identifying 878 patients who received multiple-dose activated charcoal. We judged 5 (0.6%; 95% confidence interval [CI] 0.1% to 1.1%) patients to have had clinically significant pulmonary aspiration and none (0%; upper 95% CI 0.3%) to have had gastrointestinal obstruction. None of the patients with pulmonary aspiration died or had residual sequelae recorded. Hypernatremia (peak serum sodium >145 mEq/L [145 mmol/L]) was documented in 53 (6.0%; 95% CI 4.4% to 7.6%) patients, of whom 5 (0.6%; 95% CI 0.1% to 1.1%) had a serum sodium concentration of greater than 155 mEq/L (155 mmol/L). Hypermagnesemia (peak serum magnesium >2.5 mg/dL [1.0 mmol/L]) was documented in 27 (3.1%; 95% CI 2.0% to 4.2%) patients, of whom 3 (0.3%; 95% CI 0.1% to 1.0%) had peak values that were greater than 3.75 mg/dL (1.5 mmol/L). One patient had a corneal abrasion (0.1%; 95% CI 0% to 0.6%). No other complications were identified. Conclusion: Clinically significant complications associated with the use of multipledose activated charcoal occur infrequently.

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