Potential misuse of ipecac
Abstract
STUDY OBJECTIVE: To evaluate the use of ipecac by health care professionals.
DESIGN: A descriptive case series based on a one-year review of all calls to a poison center.
SETTING: A university hospital-affiliated regional poison center.
INTERVENTIONS: The use of ipecac was judged appropriate or inappropriate based on the consensus of three professionals associated with the poison center using predetermined contraindications.
MEASUREMENTS AND MAIN RESULTS: In 20% of cases in which ipecac was used, its use was inappropriate. The most common inappropriate situation was that too much time had elapsed from the time of ingestion. Among adults the most common contraindication was the ingestion of a substance known to cause altered mental status. Among children, the most common contraindication was the ingestion of a nontoxic substance or amount of substance. The poison center recommended ipecac inappropriately less often than emergency departments and usually in children ingesting a nontoxic substance. EDs recommended ipecac inappropriately with a broader range of contraindications and more often in adults.
CONCLUSION: Ipecac has potentially adverse consequences and should not be used reflexively. Providers of emergency care should be educated about possible contraindications to its use.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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