Treatment of the Poisoned Child

Reid, D H

doi:10.1136/adc.45.241.428

Cited by 21 publications

(5 citation statements)

References 23 publications

(24 reference statements)

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“…Over 100 years ago, Adolf Kussmaul introduced the method of gastric lavage to clinical medicine (Reid 1970). Since then, gastric lavage has been readily used to empty the contents of a patient's stomach when a poisonous ingestion is suspected~ Theoretically, one might consider gastric lavage to be the most thorough procedure to rid the stomach of its contents; however, its effectiveness and safety depends on a number of variables.…”

Section: Gastric Lavagementioning

confidence: 99%

“…Reid (1970) showed that the average delay time between arriving at the emergency centre and receiving lavage was 26 miilutes. The time recorded for lavage was 35 minutes.…”

Section: Accessibilitymentioning

confidence: 99%

“…A number of authors have criticised the time required to collect the equipment and materials and to perform the lavage procedure (Alpert 1969;Done 1965;Gosselin & Smith 1966;Reid 1970). Others have discussed the variance in lag time required before syrup of ipecac produces emesis, reporting ranges between 14 and 24 minutes (Dabbous et al 1965;Manoguerra & Krenzelok 1978).…”

Section: Comparative Efficacy Of Emesis Versus Lavagementioning

confidence: 99%

“…A previously discussed paper by Reid (1970), involving 373 subjects over a 2-year period, showed that the time delay associated with waiting for gastric lavage at the hospital was 26 minutes. In contrast, a patient treated with syrup of ipecac could receive it immediately upon arriving at the hospital.…”

Section: Comparative Efficacy Of Emesis Versus Lavagementioning

confidence: 99%

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Gastric Emptying

1986

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This review examines the various clinical options used to elicit gastric emptying, viz. drug-induced emesis, mechanical pharyngeal stimulation, gastric lavage, and catharsis. Apomorphine and syrup of ipecac are the 2 drugs most frequently used for induction of emesis. Both agents act centrally and, in addition, syrup of ipecac has a peripheral action. Toxins ingested or foods previously eaten may inhibit or enhance emetic action by interfering with mediating and conducting mechanisms. Studies indicate that both syrup of ipecac and apomorphine are similarly effective in inducing emesis; however, apomorphine has a shorter reaction time compared with syrup of ipecac. There are more risks involved with the use of apomorphine, since it causes central nervous system and respiratory depression. Syrup of ipecac has been shown to be relatively safe when used in its recommended dosage for emesis. However, several toxicities have been reported with the use of the fluid extract of ipecac. Emesis is contraindicated in patients who are obtunded or comatose, and in patients who have ingested stimulants, some hydrocarbons, or corrosives. Mechanical pharyngeal stimulation is a simple method of inducing emesis; however, it is often unsuccessful and rarely recovers a significant portion of the gastric contents. Gastric lavage is a procedure which has been relied upon for over a century. Its effectiveness is dependent on the nature, form, and dosage of the poison, latency between time of ingestion and lavage, and technique. In clinical experiments studying gastric lavage, it has been noted that the procedure is most beneficial 1 to 2 hours postingestion for the majority of poison ingestions. Lavage also provides an excellent route for activated charcoal and selected antidotes. Gastric lavage may pose several risks to the patient, including obstruction and contamination of the airways and oesophageal damage. Contraindications for gastric lavage are similar to those for emesis except that it may be safer to use in obtunded, comatose, or uncooperative patients. Cathartics used during initial poisoning therapy are usually the saline cathartics. They elicit an osmotic reaction in the small intestine which results in increased intraluminal fluid bulk, hyperperistalsis, and subsequent propulsion of contents. Cathartics have also been shown to stimulate the secretion of cholecystokinin, which is thought to have similar effects on the intestine. Cathartics have not been shown to significantly enhance drug elimination from the gastrointestinal tract.(ABSTRACT TRUNCATED AT 400 WORDS)

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Section: Gastric Lavagementioning

confidence: 99%

“…Reid (1970) showed that the average delay time between arriving at the emergency centre and receiving lavage was 26 miilutes. The time recorded for lavage was 35 minutes.…”

Section: Accessibilitymentioning

confidence: 99%

Section: Comparative Efficacy Of Emesis Versus Lavagementioning

confidence: 99%

Section: Comparative Efficacy Of Emesis Versus Lavagementioning

confidence: 99%

See 2 more Smart Citations

Gastric Emptying

1986

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“…Sir, There may well be a place for emetics in the treatment of children who have ingested poison, as advocated by David Reid (1970). However, on the evidence at present available, it is quite unjustifiable to conclude that emesis is superior to gastric lavage in terms of safety or effectiveness.…”

Section: Treatment Of the Poisoned Childmentioning

confidence: 99%