Pediatric ingestion of seven lead bullets successfully treated with outpatient whole bowel irrigation

Schwarz, Kerry; Alsop, Judith A.

doi:10.1080/15563650802194281

Cited by 8 publications

(1 citation statement)

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“…Though many of the simulated poison studies have not demonstrated a benefit of WBI with or without AC, several case reports note improved outcomes using WBI for unusual exposures including slow-release medications such as theophylline, mercuric oxide, lead, strontium ferrite, potassium capsules and even lead bullets [53-58]. These case reports obviously lack controls or even historic controls, drawing into question whether improved outcomes were really demonstrated.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal decontamination in the acutely poisoned patient

et al. 2011

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ObjectiveTo define the role of gastrointestinal (GI) decontamination of the poisoned patient.Data SourcesA computer-based PubMed/MEDLINE search of the literature on GI decontamination in the poisoned patient with cross referencing of sources.Study Selection and Data ExtractionClinical, animal and in vitro studies were reviewed for clinical relevance to GI decontamination of the poisoned patient.Data SynthesisThe literature suggests that previously, widely used, aggressive approaches including the use of ipecac syrup, gastric lavage, and cathartics are now rarely recommended. Whole bowel irrigation is still often recommended for slow-release drugs, metals, and patients who "pack" or "stuff" foreign bodies filled with drugs of abuse, but with little quality data to support it. Activated charcoal (AC), single or multiple doses, was also a previous mainstay of GI decontamination, but the utility of AC is now recognized to be limited and more time dependent than previously practiced. These recommendations have resulted in several treatment guidelines that are mostly based on retrospective analysis, animal studies or small case series, and rarely based on randomized clinical trials.ConclusionsThe current literature supports limited use of GI decontamination of the poisoned patient.

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Section: Introductionmentioning

confidence: 99%