Gastric lavage Gastric lavage will occasionally be advised by the Poisons Centre. It should be considered only if it can be done within an hour of ingestion of a life-threatening ingestion, and only with poisons not adsorbed by activated charcoal. This is occasionally advised for potentially very severe poisoning, e.g. with iron tablets. Syrup of ipecac has no place in hospital management. If it has any use at all, this may be for emergency induction of vomiting, for poison removal, in very isolated areas, and only after consultation with the Poisons Centre.
Catharsis using magnesium sulphate or other osmotic agents has no place in poison removal.
Peritoneal dialysis, haemodialysis, forced diuresis and exchange transfusion are very rarely, if ever, necessary for poisoned children. The Poisons Centre will advise on these if necessary. However, they will be advised by the Poisons Centre if likely to be useful. In severe established poisoning, survival will often depend upon the quality of supportive care. Respiratory and circulatory support, once necessary, take precedence over all other aspects of care.