Syrup of ipecac dosing ... How much is a tablespoonful?

Syrup of ipecac is a safe and effective emetic in pediatric patients. Previous reports demonstrate that syrup of ipecac-induced emesis is dose related. The failure rate and the time for emesis to occur is significantly greater when 15 ml is used compared to 30 ml. To reduce failure rates, efforts such as consuming the entire contents of a 15 ml or 30 ml bottle of syrup of ipecac or using kitchen measuring spoons are frequently employed. Since kitchen measuring spoons and flatware are commonly used to administer 1-2 tablespoons of syrup of ipecac, we measured the delivered dose of 30 standard flatware teaspoons to determine the accuracy of the spoons. The mean dose delivered by a kitchen measuring teaspoon was 5.5 ml (range 3 ml to 6 ml) and 12.7 ml (range 10 ml to 17 ml) for measuring tablespoons. This compares to the serving flatware teaspoon mean delivery volume of 5.8 ml (range 3 ml to 7 ml) and 9.5 ml (range 7 ml to 14 ml) for the flatware tablespoon. There is a significant disparity in the delivery volume of the utensils. We recommend the use of graduated medicine spoons or administration of the contents of an entire 30 ml bottle of syrup of ipecac to ensure optimal effects.