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Despite a lack of supporting evidence, activated charcoal (AC) is widely used in acute poisoning management. Emesis often occurs after charcoal administration, however, and can cause substantial morbidity. To determine the incidence of emesis and risk factors for it in children, investigators prospectively studied 275 consecutive patients aged 18 or younger with acute poisoning who received AC at one urban emergency department. Every two weeks, the AC preparation was switched between one with and one without sorbitol.
Overall, 20% of patients vomited after initiation of AC therapy. The median time to vomiting was 10 minutes; 95% of vomiting episodes occurred within 95 minutes. Of those who vomited, 55% did so before the entire dose of AC had…