What is the general purpose of activated charcoal in ICEMA standing orders?

• A. To reduce absorption of certain ingested toxins when given promptly after ingestion and when airway is protected
• B. To promote hydration in dehydration
• C. To treat metabolic acidosis
• D. To manage seizures

Answer: (A)

Activated charcoal works by adsorbing certain ingested toxins in the gastrointestinal tract, which reduces the amount that enters the bloodstream. In ICEMA standing orders, its general purpose is to lower systemic toxin burden when given promptly after ingestion and only if the airway is protected to prevent aspiration. The benefit is greatest when administration occurs soon after ingestion (often within about an hour) and for substances that charcoal can bind. It is not a universal antidote and is not appropriate for all poisons (for example, caustics, hydrocarbons, alcohols, certain metals), and it should not be used if the patient cannot protect the airway or if there is a high risk of vomiting and aspiration.