Ipecac syrup. Its role in pediatric poisoning treatment

Gastric decontamination has been one of the main and first steps in the treatment of oral intoxication. In 1997 the American Academy of Clinical Toxicology (AACT) and the European Association of Poison Centres and Clinical Toxicologists (EAPCCT) published their position statements about this topic. The purpose of our work is to evaluate the use of ipecac and emesis at an outpatient level. The study was retrospectively carried out from 1991 to 2002 with 444 consults received at the Toxicological Information Service (SIT) in children younger than 14 years in whom emesis had already been induced. The consult was made from a primary care unit. The etiology was accidental in 92.8%. The average elapsed time since the toxic exposure and the consult was 44 minutes. The main drugs in which emesis was induced were acetaminophen, salicylates and ibuprofen; it could accomplish the indication of AACT/EAPCCT. But there were cases of emesis induction after the ingestion of products with detergents, hydrocarbons or substances that could produce neurological depression. The intoxication could also be mild and emesis was not justified. The SIT indication of emesis decreased since 1998. As a conclusion, most of the gastrointestinal decontamination procedures do not improve the outcome and can be risky for the patient whereas during the treatment there are many other safer opportunities of medical intervention.