Prewarm activated charcoal

Prewarm activated charcoal; pour into soda can. With almost all ingestions of poisons or toxic substances, you will be asked to administer activated charcoal.

Prewarming the charcoal prior to administration is helpful. "Before you lavage a patient, put the charcoal container in a basin of warm water, to warm it to body temperature," recommends Maureen Heyder, RN, CEN, an ED nurse at Dartmouth Hitchcock Medical Center in Lebanon, NH.

By the time you have finished your initial assessment and care, the charcoal will be smooth and slightly warmed, says Heyder. "It will flow easily without chunks of charcoal plugging the gastric tube," she explains. For safety, test the temperature of a few drops on your inner wrist as in testing the temperature of a baby bottle.

Convincing children to drink charcoal is another challenge. "Many a uniform has been ruined in this effort, and every ED staff person has a story to tell about trying to get kids to drink charcoal," says Carolynn Zonia, DO, FACEP, Education Division of the ED at St. Francis Hospital, Evanston, IL. "While the charcoal actually has no taste,’ it is gritty, and once kids see it, they usually won’t drink it."

Put the charcoal in an empty soda can with a straw, Zonia suggests. "If they can’t see it, you’ll have much better success with them drinking it. It does work," she says.