- Survey of Activated Charcoal Administration for Poisoning Patients Visited in Emergency Medical Centers and Emergency Staff's Perception in Korea
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Sung Jin Bae, Yoon Hee Choi, Duk Hee Lee
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J Korean Soc Clin Toxicol. 2017;15(1):17-23. Published online June 30, 2017
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DOI: https://doi.org/10.22537/jksct.2017.15.1.17
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 Abstract
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- Purpose: Activated charcoal (AC) has been widely used as a universal antidote. Currently, emergency medical centers in Korea cannot administer AC due to discontinuation of the supply of commercial ready-mixed AC suspension. This study was conducted to investigate the proportion of emergency medical centers that administer AC to poisoning patients and provide basic information for emergency physicians and toxicologists. Methods: A prospective telephone survey of all of the included emergency medical institutions was conducted. The type of emergency medical institution, average annual number of patients admitted to the emergency department, annual average number of patients who were poisoned and whether the hospital currently utilizes gastric lavage and administration of AC were determined. Results: AC was administered to poisoning patients in 40% of regional emergency medical centers, 59.3% of local emergency medical centers, and 45.9% of local emergency medical rooms. Overall, 37% of total emergency medical institutions did not administer AC due to discontinuation of the commercial ready-mixed AC suspension. Additionally, 77% of emergency physicians in institutions without AC knew AC is necessary for poisoning patients. The rate of vomiting experienced by the medical staff according to types of charcoal showed that the average rate of vomiting was 33% for commercial ready-mixed activated charcoal suspension and 51% for self-prepared charcoal powder (p=0.02). Conclusion: AC should be secured promptly in emergency medical institutions. Before the supply of commercial ready-mixed AC suspension becomes again it is essential to develop a standardized regimen for self-preparation of charcoal powder and to educate emergency physicians and toxicologists to its use.
- Administration and Efficiency Comparison of Chloral Hydrate during Pediatric Sedation
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Jung Ah Bae, Yoon Hee Choi, Ah Jin Kim, Sun Hwa Lee
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J Korean Soc Clin Toxicol. 2016;14(1):9-15. Published online June 30, 2016
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Abstract
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- Purpose: In most emergency department (ED), sedation is required before carrying out an invasive procedure on a pediatric patient. In the ED setting, it is essential to determine the optimal dose and administration route of CH for successful sedation. The aim of this study was to determine the optimal dose of CH for an invasive procedure and to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likert-scale to evaluate satisfaction of medical staffs in ED with administration routes. Methods: This study was conducted prospectively. The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea within a period of 12 months. Results: Overall, 300 patients were included in this study. The age, sex, and weight of the patients were not shown to influence the sedation time. Chloral hydrate dosage is the independent factor to influence the both sedation and discharge time (p<0.01). In the comparison of the groups, groups 1, 2, and 5 showed no significant difference. On the other hand, groups 3 and 4 were shown to be statistically significantly different from group 1. Conclusion: Up to 100 mg/kg CH is safe to use in the emergency department for pediatric patients, but the initial dose of 50 mg/kg for oral administration should be considered in advance because it can provide safe and effective sedation with a lower possibility of causing an adverse effect.
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KSCT
Korean Society of Clinical Toxicology