Activated charcoal: to give or not to give?

There has been much debate about the use of activated charcoal in patients who have taken overdoses and then present to Emergency Departments. There are clinical trials, research and position statements that have examined the effectiveness of activated charcoal in a number of overdoses of different medications, but there is still a debate surrounding the evidence based practice of administering activated charcoal in patients who have taken a drug overdose due to lack of evidence. This article will examine on the two main guidelines on activated charcoal, one produced by the National Institute for Clinical Excellence and the second produced by American Academy of Clinical Toxicology. It will discuss the methods of administration on activated charcoal, contraindications and the difficulties or challenges in adhering to these guidelines in the clinical setting. 2009 Elsevier Ltd. All rights reserved.