Methods of gastric decontamination have generated controversy among physicians treating toxin-related emergencies. A number of methods of decontamination exist, including induced emesis (by ipecac syrup, mild detergents, or apomorphine), nasogastric or orogastric lavage, and oral activated charcoal. No distinct advantages in effectiveness have been attributed to any of these methods in particular.
Charcoal is currently experiencing a resurgence of support in some publications1 and has been suggested by some authors as a replacement for emesis as a method of decontamination for nonacute poisonings. This may contribute to confusion by some practitioners and consumers who are concerned about the appropriate role of emesis in the management of poisoned patients. In some situations the characteristics of activated charcoal may make it the most appropriate mode of decontamination. Intoxication with a substance that has a rapid onset of toxicity and for which emesis would be contraindicated