POTENTIAL MISUSE OF IPECAC

Study objective: To evaluate the use of ipecac by health care professi onals. Design: A descriptive case series based on a one-year review of all calls to a poison center. Setting: A university hospital-affiliat ed regional poison center. Interventions: The use of ipecac was judged appropriate or inappropriate based on the consensus of three professi onals associated with the poison center using predetermined contraindi cations. Measurements and main results: In 20% of cases in which ipeca c was used, its use was inappropriate. The most common inappropriate s ituation was that too much time had elapsed from the time of ingestion . Among adults the most common contraindication was the ingestion of a substance known to cause altered mental status. Among children, the m ost common contraindication was the ingestion of a nontoxic substance or amount of substance. The poison center recommended ipecac inappropr iately less often than emergency departments and usually in children i ngesting a nontoxic substance. EDs recommended ipecac inappropriately with a broader range of contraindications and more often in adults. Co nclusion: Ipecac has potentially adverse consequences and should not b e used reflexively. Providers of emergency care should be educated abo ut possible contraindications to its use.