USING THE GI COCKTAIL - A DESCRIPTIVE STUDY

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.