Activated charcoal in the prehospital setting
Abstract
ACTIVATED CHARCOAL IN THE PREHOSPITAL SETTING To the Editor:-We read with interest the investigation by Allison et al. titled "Potential Time Savings by Prehospital Administration of Activated Charcoal."' We provide physician supervision in a threecounty area surrounding Portland, Oregon, using a set of regional EMS protocols. EMS services are provided to an urban, suburban, rural, and frontier mix. Since 1991, the Portland metropolitan area EMS providers have administered activated charcoal (AC) in the prehospita1 care setting2 Patients who have ingested a compound within six hours, who are conscious and alert, and who have not ingested a substance that is likely to cause a rapid change in mental status (e.g., a tricyclic antidepressant) are candidates for this intervention. On-line medical control (OLMC)is required prior to the administration2 From August 4,1995, to April 10, 1997, administration of charcoal in the prehospital setting was requested in 51 cases within the Portland area. In 50 of the 51 cases, the primary reason for contact was classified as a primary poisoning/overdose. The remaining case was a combination poisoning/overdose and trauma. Thirtythree of 50 patients were female, with a mean age of 26 years (range = 2-90 years). The OLMC physician approved of the