Before administering activated charcoal, which condition must be assured?

• A. Time since ingestion is under 5 minutes
• B. Normal blood pressure
• C. Airway protection
• D. Patient consent

Answer: (C)

Airway protection is essential before giving activated charcoal because charcoal can be aspirated into the lungs if the patient cannot protect their airway. When a patient has altered mental status, depressed gag reflex, or is vomiting, the risk of aspiration is high. Securing the airway (and ensuring the patient can maintain a patent airway) prevents charcoal from entering the airway and causing aspiration pneumonitis. Once the airway is secure, activated charcoal can be administered to bind the toxin in the GI tract and reduce absorption. Time since ingestion matters for effectiveness, but it does not replace the need for an assured airway. Normal blood pressure or obtaining consent are not the immediate prerequisites in this emergency scenario.