Single–dose activated charcoal—a feasibility study in an ambulance setting

In 2004, a clinical guideline from the National Institute for Health and Care Excellence (NICE) recommended that the evidence supported administration of single-dose activated charcoal (SDAC) within 1 hour of toxin ingestion and that ambulance services were ideally placed to deliver this treatment (NICE, 2004).

A survey the following year (Greene et al, 2005) found that no ambulance services had adopted the treatment, citing concerns which included the lack of a protocol aimed at ambulance staff, increased time on scene, and vomiting by patients with associated ambulance cleaning and increased turnaround times.

A literature review conducted by South Western Ambulance Service NHS Foundation Trust (SWASFT) in 2012—detailed in a previous article (Walker, 2013)—concluded that sufficient evidence of clinical benefit existed to warrant a trial of SDAC as a treatment within SWASFT.

The primary aim of the trial was to evaluate the feasibility of crews carrying and administering the medication to suitable patients in a pre-hospital setting, in particular examining the concerns raised by ambulance Trusts in the paper by Greene et al (2005). The secondary aim was to describe the patient demographic of those receiving or refusing the treatment offered.