They found NO significant difference between groups with respect to length of admission, average ICU time, duration of tachycardia, or time on a ventilator. Differences in outcome may have been missed because of the small number of patients. Each method of decontamination may have particular merit for different types of patients in different ED settings. This study should not be over-interpreted. It does not prove that activated charcoal alone is effective in all tricyclic antidepressant overdoses.
Gastric decontamination remains a highly controversial area in the management of poisoned patients.
At this time it is clinically acceptable to treat selected overdose patients with activated charcoal alone. The author found 39 symptomatic beta blocker overdoses in a retrospective literature review of the past three decades. One patient developed bradycardia 3 to 4 hours after ingestion, and 6 hours after ingestion that patient developed profound hypotension. No patient developed symptoms more than 6 hours after ingestion. Emergency department observation for 6 hours after a beta-blocker overdose appears to be sufficient to exclude a clinically significant overdose.