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Activated charcoal in paracetamol overdose
  1. Katrina Richell-Herren,
  2. Magnus Harrison
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL

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    Report by Katrina Richell-Herren, Research Fellow Search checked by Magnus Harrison, Research Fellow

    Clinical scenario

    A 23 year old woman attends the emergency department having taken 60 500 mg paracetamol tablets two hours before presentation. You wonder whether she should receive activated charcoal.

    Three part question

    In [patients poisoned with paracetamol] does [activated charcoal alone or in combination with other treatments] reduce [hepatotoxicity]?

    Search strategy

    Medline 1966–03/00 using the OVID interface. [({acetaminophen.mp OR paracetamol.mp} AND {exp poisoning OR poisoning.mp OR exp overdose OR overdose.mp}) AND {exp charcoal OR charcoal.mp} LIMIT to human AND english.

    Search outcome

    Altogether 71 papers found of which 68 were irrelevant or of insufficient quality. The remaining three papers are shown in table 3.

    Table 3

    Comments

    There are no high quality studies in this area. In particular there are no data to indicate how long after poisoning activated charcoal remains effective.

    Clinical bottom line

    Activated charcoal should be given to all patients with significant paracetamol poisoning who present acutely.

    Report by Katrina Richell-Herren, Research Fellow Search checked by Magnus Harrison, Research Fellow

    References

    View Abstract

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