Study objective: To determine practice patterns regarding administrati
on of the ''GI cocktail'' (a mixture of liquid antacid, viscous lidoca
ine, and an anticholinergic) in the emergency department in a single h
ospital and the responses and final dispositions of patients who recei
ved the cocktails. Design: A retrospective review of ED charts. Settin
g: Urban university hospital ED with an annual census of 50,000 visits
. Participants: Ninety-seven consecutive patients who received a GI co
cktail in the ED. Results: Forty-nine patients (50%) received a GI coc
ktail for a chief complaint of abdominal pain and 40 (41%) for a chief
complaint of chest pain. The reason for administration of a GI cockta
il was documented on only one chart. Sixty-six patients (68%) received
at least one other drug, at a median time of 9 minutes before adminis
tration of the GI cocktail. The most commonly coadministered drug was
a narcotic (56 patients), followed by nitroglycerin (22 patients), ant
iemetics (13 patients), H-2-blockers (13 patients), and aspirin (10 pa
tients). Thirty-three patients (34%) had symptomatic relief with the c
ocktail alone, 35 (36%) had symptomatic relief with the cocktail plus
other drugs, 7 (7%) had no response to the GI cocktail alone, and 5 (5
%) had no response to the cocktail with other drugs. In 17 patients (1
8%) the response was not documented. Chest pain patients and abdominal
pain patients had a similar frequency of response. There was also sim
ilarity of response between admitted and discharged patients. Conclusi
on: Although symptomatic relief after administration of a GI cocktail
is often noted, it is difficult to differentiate the effects of the co
cktail from those of other coadministered medications such as morphine
or nitroglycerin. We urge ED physicians to use the GI cocktail in a r
ational manner.