Monday, 4 April 2011

Poisoning in Children, Activated Charcoal (the Universal Antidote)

When I was a child I made my parents suffer due to my passion for science (like the baby on image 1). Oh yeah they suffered really badly. Countless deeds this fellow blogger lived that enhanced the passion for domestic recreational science, countless times they argued about the reasons I had fallen sick, again and again and again until the age of 12. No, I wasn’t unhealthy at all; in fact I believe I was a very healthy kid when weighting all the crazy experiments I developed in my room, my grandma’s farm, the forest behind my neighbourhood and even my town’s sewers network. I did go crazy experimental motivated not only by TV star MacGyver (Richard Dean Anderson) but also by a terrible impatience and a struggle against a very tedious educational system. You want to have a go on the list of dumb things I did until the age of 12? Here we go! I tasted many forbidden pesticides when my grandfather used to shower the vineyard and right after that I was engulfing a handful of toxic sulphates just because I couldn’t run a few meters to wash a bunch of grapes properly, I got slightly electrocuted when driven by an engineering book telling me how to assemble a magnet worked out by a simple copper-wire, a metal paper clip and a pair of batteries; I felt gravity’s pull right before falling down a tree of around three floors height to luckily land on a sand-hill some constructors innocently/unconsciously left there for saving my life, I had a terrible food poisoning due to an egg/flour mixture I honestly believed could make me the stronger kid in the neighbourhood after some taller/tougher kids terrorised me for several days on the way home from school (this actually drove me to the hospital several times always surprisingly escaping from a Salmonellosis) and I had severe rashes caused by fleas when using the sewers for military actions (I really thought I was part of Delta Force and would save the world, somehow... when my worst enemy were rats the size of a football ball, either proper football or soccer for the Americans - well, we'll discuss how toxic it is for us Europeans to see the Master Sports be named after "soccer" one of these days!!). I messed up my childhood Big Time every time I was watching something interesting on TV or reading some nice science books at the library.

What the last paragraph intended to do was to show you that we have all been kids one day. And probably now you have your own kids and you do struggle to keep them quiet and disable their interest for dangerous actions. Well, if I can advise you in any way, based on the experience I have as a person, a 32 years old individual who survived to the craziest experiments, some so dangerous I believe they are probably illegal in several countries (like escalating to my grandma’s attic because I wanted to verify if I was tough enough to live on my own for a whole week there, just surviving on home baked bread and comics)..., please, DON’T DO THAT TO YOUR CHILDREN. Let them live and experiment, and try and fail, then try again and succeed, so they can have a real taste of what life, science and the universe is all about. All you should ask from yourself is to keep an eye, at all times, so they don’t harm themselves, get hurt or something terribly serious happen. If you embark with your children on trying and experimenting they will become more aware of the variables involved in the forces of nature, like that time I learned that jumping from the back of a moving van had to end in several stitches and a lot of blood, or like that other time when I built a gravity racer and nearly ended facing death whilst sliding down a hill towards the main road, quite innocently but dead happy!

Keep an eye on your children, supervise everything they do, communicate to them, answer questions and instigate their curiosity in the safest way possible, but by all means, never limit their willingness to learn. Having said that I believe that the best thing I could do for you all, concerning mums and dads of this world, is to offer you a list on the antidotes for several poisons and toxicants people can find throughout one’s life; the commonest and some actually disregarded as hazardous but known to hospital staff due to their harmfulness. This list will be presented by The Toxicologist Today as this new tag progresses through time, nevertheless bear in mind that it does not dispense consulting immediate medical support from proper clinical staff in case of an emergency. The summary of advises I'll be presenting and the list I’ll be adding up to is just working as supporting info to get you warmed up for what’s coming as parents. Just in case your kids go nuts. For those who are still single or just have no kids to worry about, believe me, this information is always precious, regardless.

But first things first! For those not entirely familiarised with the idea of antidote, an Antidote is by definition a medicinal substance that specifically prevents, counteracts, reverses or relieves the effects caused by a toxicant agent [1]. Antidotes, as well as toxicants, are potentially harmful and should not be used indiscriminately. Always remember that!!! Some might know that for decades a "Universal Antidote" has been used against the majority of poisons, toxins and toxicants just due to the capacity of preventing the absorption of the latter from the gastrointestinal tract, and also because it does help enhance the elimination of certain toxic elements already absorbed [2]. I am talking about Activated Charcoal (2nd image). Is it safe? As far as I could find out if used appropriately activated charcoal has low morbidity [2] (recent comparative studies found no difference in hospital length, morbidity and mortality between groups who received and not received activated charcoal), nevertheless this is a field needing far more studies to prove the clinical benefits in using activated charcoal routinely in ingestions. As stated by Lapus (2007) "Activated charcoal could be considered for patients with an intact airway who present soon after ingestion of a toxic or life-threatening dose of an adsorbable toxin. The appropriate use of activated charcoal should be determined by the analysis of the relative risks and benefits of its use in each specific clinical scenario".

An article published in July, 1989, in the Journal of Mega Health Society spoke of activated charcoal as a "highly absorbent gritty black material":

How is is created?

"...by carbonizing organic matter in a kiln under anaerobic conditions and activating the material with oxidizing gases like steam or air at high temperatures. This oxidative process erodes the charcoal's internal surfaces and increases its adsorption capacity by creating an internal network of very fine pores. Usually bone char, coconut shells, peat, coal, petroleum coke, and sawdust are the starting materials for making Activated Charcoal." [3]

When was it first used?

"The medical uses for charcoal date back to the Egyptian Papyrus of 1550 B.C. During the time of Hippocrates (400 B.C.) physicians treated epilepsy and anthrax with charcoal. In the 1700's charcoal was often prescribed for bilious problems (excessive bile excretion). After the development of the charcoal activation process (1870 to 1920), many reports appeared in medical journals about Activated Charcoal as an antidote for poisons and a cure for intestinal disorders." [3]

When should activated charcoal be taken up?

"Activated Charcoal should be taken within 30 minutes of ingesting the poison. The longer the delay, the less effective Activated Charcoal will be. On some poisons delaying more than 30 minutes decreases the effectiveness of the Activated Charcoal as an antidote by up to 60%." [3]

It would be wrong of me to copy/paste the full length of this great article. An article that offers you extra great references too, but you can find it online for free viewing right here. Also the Institute of Science and Technology, on their website, introduces a recipe of activated charcoal that can be used by medical aid consisting of:

Activated powdered charcoal 2 parts by weight:

Magnesium oxide 1 part by weight
Tannic acid 1 part by weight

The mixture should be stored dry and when required for use, add 15g to half a glass of warm 
water.

C y a n i d e   A n t i d o t e s
For inhaled cyanides the patient should be allowed to inhale amyl nitrate for 15-30 seconds 
every 2-3 minutes for a maximum of 15 minutes.

For ingested cyanides, if the patient is conscious allow him to drink the following:
Solution A 158g of ferrous sulphate plus 3g of citric acid made up to 1 litre in cold distilled water
Solution B 60g of anhydrous sodium carbonate made up to 1 litre in 
cold distilled water.

The solutions are stored separately and equal volumes are mixed when required for use.

Another recipe I found, but unfortunately I have no idea where exactly I got it from, therefore, cannot rely on the structure and solidness of the information presented, is the one adding magnesia milk, a strong tea and activated charcoal:

2 part of wood charcoal pulverised (you can also use burned toast, yet the toast must be totally carbonized & pulverized). Then add 1 part of magnesia milk & 1 part of very strong tea. If your child has swallowed a toxic product, give him as FAST as You can in a little bit of water at least 2 tablespoon of this mixture.

How does it work: If the poison is metallic or alkaline, the tannic acid contained in the tea will neutralize it. If the poison is acid, the magnesia will neutralize it. The wood charcoal even at very little dose, can absorb very strong quantities of toxic.



Simple, isn't it? As simple as the tablets like the ones on image 3. Simple and can actually save a child's life. As long as you play by the rules and always ask for immediate medical assistance, the step of inhibiting a poisonous absorption from the organism of the affected child is a life saver. I definitely hope you never have to put this to practice, but if you have to The Toxicologist Today is here to help you and to let you know about it. See you soon on an amazing upcoming article that will scrutinise the science recruitment agencies.

[1] - Hare, W., Post, L. O., Oehme, F., (year unknown). "A review of veterinary antidotes". Journal unknown. 

[2] -  Lapus, R. M., (2007). "Activated charcoal for pediatric poisonings: the universal antidote?". Current Opinion in Pediatrics, 19(2), pp. 216-222.

[3] - Kaufman, R. C, (1989)."The Universal Antidote and Detoxifier That Extends Life: Activated Charcoal". Journal of Mega Health Society

[4] - Universal Antidote for Poisons, Institute of Science and Technology, http://www.istonline.org.uk/Handbook/39.pdf, last update unknown, last visited on the 04th of April 2011.


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