Gastrointestinal decontamination for enteric-coated aspirin overdose: Whatto do depends on who you ask

Context: Overdoses with enteric-coated preparation are common, The optimal means by which to limit drug absorption in such cases is controversial, Obj ective: To describe the recommendations for gastrointestinal decontaminatio n issued by North American poison control centers for a hypothetical patien t, tan adult male with normal vital signs), presenting 1 hour after ingesti ng 500 mg/kg of enteric-coated aspirin, Design: Telephone survey of 76 pois on control centers in North America. Seven toxicologists who contributed to the American Academy of Clinical Toxicology/European Association of Poison Centres and Clinical Toxicologists position statements on gastrointestinal decontamination were also surveyed for informal comparison. Results: Most poison control centers (99%) and all of the toxicologists (100%) participat ed in the survey. Four centers (5%) recommended syrup of ipecac and 38 (51% ) recommended gastric ravage, compared with 0% and 0% of toxicologists, res pectively. Seventy-three centers (97%) recommended at least one dose of act ivated charcoal, compared with 6 toxicologists (86%), Twenty-one poison cen ters (28%) recommended whole-bowel irrigation, compared with 3 toxicologist s (43%), A total of 36 different courses of action were suggested by respon dents at the poison centers. Some of these recommendations were potentially harmful, Conclusions: Considerable variability exists in the recommendatio ns of North American poison control centers for the gastrointestinal decont amination of patients with large, acute overdoses of enteric-coated aspirin .