How does activated charcoal work as an emergency treatment for poisoning. What are the benefits and limitations of using activated charcoal for drug overdoses. When should activated charcoal be administered for maximum effectiveness. How is activated charcoal prepared and given to patients in emergency situations.

The Science Behind Activated Charcoal’s Adsorptive Properties

Activated charcoal is a remarkable substance with an extraordinary ability to bind toxins and prevent their absorption in the body. But how exactly does it work? Activated charcoal is created through a special process that dramatically increases its surface area and binding capacity. By burning carbon-rich materials like wood at extremely high temperatures, charcoal is formed. This charcoal then undergoes an “activation” process that creates countless microscopic pores and crevices in each particle.

The result is a black, odorless powder with an astonishing amount of surface area. To put it in perspective, just one teaspoon of activated charcoal has about the same total surface area as an entire football field. This massive surface area allows activated charcoal to adsorb (bind to its surface) a wide range of substances, including many drugs and toxins.

How does activated charcoal prevent toxin absorption?

When ingested, activated charcoal travels through the gastrointestinal tract, binding to poisons and drugs along the way. By trapping these substances on its surface, activated charcoal prevents them from being absorbed into the bloodstream through the gut. This effectively stops the toxic effects of many ingested poisons before they can take hold in the body.

The History and Evolution of Activated Charcoal as an Antidote

The use of activated charcoal as an antidote has a fascinating history dating back over 200 years. In 1813, French chemist Michel Bertrand made a bold demonstration of activated charcoal’s protective abilities. In a daring experiment, Bertrand ingested a lethal dose of arsenic trioxide – 5 grams – mixed with activated charcoal. Remarkably, he survived, providing early evidence of activated charcoal’s potential as an antidote.

Since then, activated charcoal has been used for various purposes, from water purification to treating ailments. However, its most important modern application is as an emergency treatment for poisoning and drug overdoses in hospital settings.

When did activated charcoal become a standard treatment for poisoning?

Activated charcoal gained widespread acceptance as a treatment for poisoning in the mid-20th century. As research demonstrated its effectiveness and safety, it gradually replaced more invasive methods like gastric lavage (stomach pumping) as the preferred first-line treatment for many types of poisoning. Today, it is the most commonly used method of gastrointestinal decontamination in emergency rooms worldwide.

Administering Activated Charcoal in Emergency Situations

In an emergency room setting, activated charcoal is typically administered as a liquid suspension. The fine black powder is mixed with water or another liquid to create a drinkable solution. For children, it may be mixed with a sweet beverage to improve palatability. Some formulations also include sorbitol, a sweetener that acts as a laxative to help move the charcoal and bound toxins through the digestive system more quickly.

How much activated charcoal is typically given?

The dose of activated charcoal depends on the patient’s age, weight, and the specific poison involved. For adults, a typical dose might be 50-100 grams. This is equivalent to hundreds of the 250 mg activated charcoal tablets sold over-the-counter, highlighting why professional medical administration is crucial.

The Efficacy of Activated Charcoal: Timing is Critical

The effectiveness of activated charcoal as an antidote is highly dependent on how quickly it is administered after poison ingestion. The sooner activated charcoal is given, the more effectively it can bind to toxins before they are absorbed into the bloodstream.

What is the optimal timeframe for administering activated charcoal?

Ideally, activated charcoal should be given within one hour of poison ingestion for maximum effectiveness. However, it can still be beneficial when administered up to 4 hours after ingestion in some cases, particularly for substances that delay gastric emptying or for extended-release medications.

Limitations and Contraindications of Activated Charcoal

While activated charcoal is a powerful tool in treating many types of poisoning, it is not effective for all substances. It works best for organic compounds and many medications but is less effective for metals, alcohols, and corrosive substances.

When should activated charcoal not be used?

• In cases of corrosive poisoning (strong acids or alkalis)
• When the patient is at risk of aspiration
• For ingestion of petroleum products
• When the poison does not bind well to charcoal (e.g., lithium, iron, lead)

Additionally, activated charcoal should only be given to alert patients who can swallow safely, as there is a risk of aspiration in very drowsy or unconscious individuals.

Potential Side Effects and Precautions

While generally well-tolerated, activated charcoal can have some adverse effects. The most common side effects include:

• Nausea and vomiting, often due to the gritty texture of the mixture
• Black stools
• Constipation

In rare cases, more serious complications can occur, such as aspiration of the charcoal into the lungs if the patient vomits. This risk underscores the importance of administering activated charcoal only under medical supervision.

Can activated charcoal interact with other medications?

Yes, activated charcoal can potentially bind to and reduce the effectiveness of other medications. This is why it’s crucial for healthcare providers to consider the timing of activated charcoal administration in relation to other treatments and to monitor patients closely.

The Dangers of DIY Activated Charcoal Treatment

Despite the availability of over-the-counter activated charcoal products, attempting to treat poisoning or overdose at home is extremely dangerous and strongly discouraged by medical professionals. There are several reasons for this:

1. Over-the-counter products may not be as “activated” or effective as medical-grade charcoal.
2. The correct dosage is difficult to determine without medical expertise.
3. Proper administration technique is crucial to avoid complications.
4. Poisoning cases often require additional medical interventions and monitoring.

Why are homemade charcoal remedies ineffective and dangerous?

Some internet sources suggest using homemade activated charcoal or alternatives like burned toast or barbecue briquettes. These are not only ineffective but can be extremely dangerous. These materials lack the high surface area and adsorptive properties of properly activated charcoal and may introduce additional harmful substances into the body.

The Role of Poison Control Centers in Guiding Treatment

Poison Control Centers play a crucial role in managing poisoning cases and guiding the appropriate use of activated charcoal. These centers are staffed by experts who can provide immediate advice to both the public and healthcare professionals on how to handle specific poisoning situations.

How do Poison Control Centers assist in poisoning cases?

Poison Control Centers offer 24/7 telephone support, providing:

• Assessment of poisoning severity
• Recommendations for appropriate treatments, including whether activated charcoal is indicated
• Guidance on proper dosing and administration of activated charcoal
• Advice on additional interventions or monitoring needed

In cases where activated charcoal is recommended, Poison Control experts can provide specific instructions tailored to the individual situation, ensuring the most effective and safe use of this important treatment.

Beyond Poisoning: Other Applications of Activated Charcoal

While its primary medical use is for treating poisoning and overdoses, activated charcoal has found applications in various other fields. Its powerful adsorptive properties make it useful in a range of contexts:

What are some alternative uses for activated charcoal?

• Water purification: Activated charcoal filters can remove contaminants from water.
• Air filtration: It can adsorb odors and pollutants from the air.
• Skincare: Some beauty products incorporate activated charcoal for its purported detoxifying effects.
• Dental hygiene: Certain toothpastes include activated charcoal, claiming to whiten teeth and freshen breath.
• Digestive health: Some people use activated charcoal supplements to reduce gas and bloating, though scientific evidence for this use is limited.

It’s important to note that while these applications capitalize on activated charcoal’s adsorptive abilities, they are distinct from its critical role in emergency medicine. The effectiveness and safety of activated charcoal in these alternative uses vary, and more research is needed in many cases.

The Future of Activated Charcoal in Medicine

As medical science advances, researchers continue to explore new applications and refine existing protocols for activated charcoal use. While it remains a cornerstone of poisoning treatment, ongoing studies are investigating its potential in other areas of medicine.

What new developments are emerging in activated charcoal research?

Some areas of current interest include:

• Improved formulations for easier administration and better palatability
• Targeted activated charcoal products designed to bind specific toxins more effectively
• Potential applications in managing certain chronic conditions, such as kidney disease
• Exploring the use of activated charcoal in combination with other treatments to enhance overall efficacy in poisoning cases

As research progresses, our understanding of activated charcoal’s capabilities and limitations continues to evolve, potentially opening up new avenues for its use in healthcare.

Education and Prevention: Key Components in Poisoning Management

While activated charcoal is an invaluable tool in treating poisoning, prevention remains the best approach. Public education about poison risks and proper storage of medications and chemicals is crucial in reducing poisoning incidents.

How can individuals reduce the risk of poisoning?

Some key prevention strategies include:

• Storing medications and household chemicals out of reach of children
• Using child-resistant packaging
• Properly disposing of unused or expired medications
• Being aware of potential poison hazards in the home and workplace
• Keeping the Poison Control Center number (1-800-222-1222 in the US) easily accessible

By combining effective treatments like activated charcoal with strong prevention efforts, we can significantly reduce the impact of poisoning incidents and save lives.

Activated charcoal | Poison Control

The Bottom Line

Activated charcoal keeps swallowed drugs and poisons from being absorbed from the gut into the bloodstream. It’s a highly effective treatment for many poisons.

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The Full Story

When people have to go to an emergency room because of an overdose, they are often worried about getting their stomachs “pumped.” In reality, gastric lavage (stomach pumping) does not happen very often. Most overdoses are treated with supportive care. For example, if the person’s blood pressure is low, IV fluids and medications might be given to raise blood pressure. There are also a few specific antidotes that can be of great benefit. However, when gastrointestinal decontamination is performed, it is typically accomplished with a product known as “activated charcoal,” mixed and taken by mouth or feeding tube in the emergency room.

Activated charcoal is a special form of carbon that can bind other substances on its surface (adsorption). That is why it is used for water filtration. It is also used to adsorb drugs in the gut so the drugs don’t enter the body. Activated charcoal is made by burning carbon-rich materials, such as wood, at very high temperatures to create charcoal. The resulting product is a black, odorless powder. The charcoal is then “activated” through a special process that makes lots of holes and crevices on the charcoal particles to increase surface area and available binding sites. One teaspoonful of activated charcoal has about the same total surface area as a football field! In the emergency room, the black powder is mixed with a liquid and given to a poisoned patient to drink. It is typically mixed with water but it can be mixed with a sweet beverage for children. Some activated charcoal products contain a sweetener called sorbitol that adds sweetness and is also a laxative. Some studies show that pushing the poison or drug through the gut faster might also decrease the amount that is absorbed into the body.

Activated charcoal has historically been used to clean water and as a treatment for many ailments. An early demonstration of the adsorptive properties of activated charcoal occurred in 1813 when the French chemist Bertrand drank 5 grams of arsenic trioxide (a very poisonous substance) mixed with activated charcoal and survived.

The efficacy of activated charcoal depends on how quickly it is given and the poisonous substance swallowed. The sooner activated charcoal is given after a drug or chemical is swallowed, the better it works.

Some activated charcoal products sold over-the-counter make claims of adsorbing toxins and decreasing bad breath. It is not recommended to use activated charcoal at home to treat an overdose. If a poisoning is serious enough to warrant the use of activated charcoal, the person should be monitored in an emergency room. Over-the-counter products might not be as “activated” as the activated charcoal used in the emergency room so they might not be as effective. Over-the-counter activated charcoal typically comes in 250 mg tablets. To provide the same dose given in the emergency room could require hundreds of tablets.

There are some internet sites that encourage making activated charcoal at home or using other carbon sources such as burned toast or charcoal briquettes. These products are not effective and should never be used.

The few adverse effects of activated charcoal are:

• nausea and vomiting after drinking it, often in response to the gritty feeling of the mixture, and 
• vomiting and inhaling (aspirating) the activated charcoal. This could happen if the patient is very drowsy.

Overall, activated charcoal is well tolerated. There are studies that show that it works well for some ingestions and not so well for others. It is the most widely used method of gastrointestinal decontamination in emergency rooms today. 

Pela Soto, PharmD, BSHS, BS

Certified Specialist in Poison Information

Poisoned?

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1-800-222-1222


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Prevention Tips

• Do not try to treat an overdose with activated charcoal at home.
• Do not confuse burned toast or barbecue briquettes with activated charcoal; they don’t work.

This Really Happened

A physician called Poison Control from the ER to discuss a patient who had intentionally taken aspirin tablets in an effort to harm herself.  The ingestion was approximately 45 minutes earlier. The patient was awake and alert, but tearful. She claimed to have taken “several handfuls” of aspirin.

Poison Control recommended that the patient receive activated charcoal as soon as possible. It was also recommended that the emergency physician measure the aspirin concentration in her blood every 2 hours until the aspirin concentration dropped. Poison Control also recommended other laboratory tests appropriate for an aspirin overdose.

During a follow-up call from Poison Control, the nurse caring for the patient reported that the patient drank the activated charcoal without issue. Her blood aspirin concentration initially rose but then declined steadily. Once the blood aspirin concentration was down to a safe range, the patient was medically cleared and transferred to a psychiatric facility. No permanent damage was anticipated. 

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For More Information

Mayo Clinic. Activated Charcoal [Internet]. Rochester (MN). 2014 December [cited 2015 Feb 27]. 

References

Chyka PA, Seger D, Krenzelok EP, Vale JA. American Academy of Clinical Toxicology and European Association of Poison Centres and Clinical Toxicologists. Position paper: Single-dose activated charcoal. Clin Toxicol (Phila) 2005;43(2):61-87.

Hoffman RS, Howland M, Lewin N, Nelson L, Goldfrank L. Goldfrank’s toxicologic emergencies. 10th ed. New York: McGraw-Hill; c2011. A1 Antidotes in depth: activated charcoal; p.108-13.

University of Kentucky. Historical production and use of carbon materials. [Internet]. 2015 January [cited 2015 Feb 27].

Erickson T. Famous (And Not So Famous) Events In Toxicological History; Activated Charcoal: Universal Antidote or Black Magic. [Internet]. AACTion Volume 13, Number 2. [Accessed 27 February 2015].

Poisoned?

Call


1-800-222-1222


or

HELP ME online

Prevention Tips

• Do not try to treat an overdose with activated charcoal at home.
• Do not confuse burned toast or barbecue briquettes with activated charcoal; they don’t work.

This Really Happened

A physician called Poison Control from the ER to discuss a patient who had intentionally taken aspirin tablets in an effort to harm herself.   The ingestion was approximately 45 minutes earlier. The patient was awake and alert, but tearful. She claimed to have taken “several handfuls” of aspirin.

Poison Control recommended that the patient receive activated charcoal as soon as possible. It was also recommended that the emergency physician measure the aspirin concentration in her blood every 2 hours until the aspirin concentration dropped. Poison Control also recommended other laboratory tests appropriate for an aspirin overdose.

During a follow-up call from Poison Control, the nurse caring for the patient reported that the patient drank the activated charcoal without issue. Her blood aspirin concentration initially rose but then declined steadily. Once the blood aspirin concentration was down to a safe range, the patient was medically cleared and transferred to a psychiatric facility. No permanent damage was anticipated. 

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Activated carbon. Great Russian Encyclopedia

Chemical compoundsChemical compounds

Activated carbon (active carbon), carbon absorbent with a developed porous structure. At 87–97% (by mass) it consists of carbon C, it also contains hydrogen H, oxygen O and substances introduced into activated carbon during its production. The ash content of activated carbon can be 1–15% (sometimes it is anesthetized to 0.1–0.2%).

Pores in activated carbon are classified according to their linear dimensions x (half-width – for slit-like pore model, radius – for cylindrical or spherical): x ⩽ 0.6–0.7 nm – micropores; 0.6–0.7< х< 1.5–1.6 nm – supermicropores; 1.5–1.6 < x < 100–200 nm – mesopores; x > 100–200 nm – macropores.

For adsorption in micropores (specific volume 0.2–0.6 cm ³ /g), commensurate in size with adsorbed molecules, the volume filling mechanism is mainly characteristic. Similarly, adsorption also occurs in supermicropores (specific volume 0.15–0.2 cm ³ /g) – intermediate areas between micropores and mesopores. In this region, the properties of micropores gradually degenerate, while the properties of mesopores appear.

The mechanism of adsorption in mesopores consists in the sequential formation of adsorption layers (polymolecular adsorption), which ends with the filling of pores by the mechanism of capillary condensation. For ordinary activated carbons, the specific mesopore volume is 0.02–0.10 cm ³ /g, the specific surface area is from 20 to 70 m ² /g; however, for some activated carbons (for example, clarifying ones), these figures can reach 0.7 cm ³ /g and 200–450 m ² /g, respectively.

Macropores (specific volume and surface, respectively, 0.2–0.8 cm ³ /g and 0.5–2.0 m ² /g) serve as transport channels that bring molecules of absorbed substances to the adsorption space of grains ( granules) of activated carbon. To impart catalytic properties to coal, as a rule, special additives are introduced into macro- and mesopores.

Activated carbon often contains all types of pores, and the differential distribution curve of their volume by size has 2-3 maxima. Depending on the degree of development of supermicropores, activated carbons are distinguished with a narrow distribution (these pores are practically absent) and wide (substantially developed).

Activated carbons adsorb vapors of substances with relatively high boiling points (e.g. benzene) well, volatile compounds worse (e.g. NH ₃ ). At a relative vapor pressure p _p / p _us less than 0.10–0.25 (p _p is the equilibrium pressure of the adsorbed substance, p _us is the saturation vapor pressure). Activated carbon slightly absorbs water vapor. However, at (р _р / р _us ) > 0.3–0.4, noticeable adsorption is observed, and in the case of (р _р / р _us )≈1, almost all micropores are filled with water vapor. Therefore, their presence can complicate the absorption of the target substance.

The main raw materials for the production of activated carbon are coal semi-coke, carbonaceous plant materials (eg charcoal, peat, sawdust, nut shells, fruit pits). The carbonization products of this raw material are subjected to activation (in most cases, steam-gas – in the presence of vapor H ₂ O and CO ₂ , less often – chemical, i.e. in the presence of metal salts, for example ZnCl ₂ , K ₂ S ) at 850–950 °C. In addition, activated carbon is obtained by thermal decomposition of synthetic polymers (for example, polyvinylidene chloride).

Activated carbon is widely used as an adsorbent to absorb vapors from gaseous emissions (for example, to purify air from CS ₂ ), to capture vapors of volatile solvents for the purpose of their recovery, to purify aqueous solutions (for example, sugar syrups and alcoholic beverages), drinking and waste water, in gas masks, in vacuum technology, for example, for creating sorption pumps, in gas adsorption chromatography, for filling odor absorbers in refrigerators, purifying blood, absorbing harmful substances from the gastrointestinal tract, etc. Activated carbon is also a carrier of catalytic additives and polymerization catalyst.

N. S. Polyakov. First publication: Chemical encyclopedia, 1988. Publication date: June 5, 2023 at 13:14 (GMT+3)

#Artificial materials

Artificial materials

Charcoal does not lose its relevance today

Charcoal coal – organic material consisting of carbon, hydrogen, oxygen and about three percent of mineral impurities (ash).

Properties

Charcoal is distinguished by its porosity, high carbon content, sorption capacity (actively absorbs water and gases). It is a brittle blue-black material. Density depends on the method of preparation, on the final temperature of dry distillation in the absence of air, as well as on the feedstock (on the type of wood).

In different grades of charcoal, the percentage of carbon can vary from 70 to 95. The more carbon and the higher the density, the higher the grade of coal. The best grade “A” is made from birch and hardwoods such as oak and beech.

Charcoal is resistant to high temperatures, aggressive chemicals, organic solvents. It is paramagnetic, i.e. absorbs magnetic radiation. This is a more environmentally friendly fuel than coal, its combustion is not accompanied by the emission of greenhouse gases and harmful gases into the atmosphere.

In many areas of the economy, activated carbon is in demand, which is obtained by processing grade A charcoal. The result is a highly porous material with a large internal surface area and a carbon content of at least 94%. Activated carbon is also produced in several grades, the best is BAU-A coal – birch activated carbon.

Charcoal is very hygroscopic, so it should be stored indoors, preferably in moisture-proof bags.

Due to the shortage and long period of reforestation, technologies for processing into charcoal waste from sawmills, furniture factories, and wood processing enterprises are being actively developed.

Applications

— Nearly half of all charcoal produced is used as a high-energy fuel — for lighting barbecues, barbecues, barbecues at home and in restaurants; for home ovens.
Special quick-burning coal is used in hookahs.
– Due to its low ash content, it is used to obtain solid lubricants for machines and machine tools.
– In the chemical industry – a popular plastic filler.
– To obtain carbon disulfide, which is necessary in the production of viscose, as well as to obtain carbon tetrachloride solvent.
– It is used as a reducing agent in the smelting of non-ferrous metals, their alloys, steel, ferroalloys, high purity crystalline silicon for the radio-electronic industry.
– Charcoal is in demand in the production of high-quality pig iron as an alternative to coke, especially in countries with a shortage of coking coal. Cast iron, cast using charcoal, does not contain harmful impurities of sulfur and phosphorus, more durable and durable.
– Charcoal is processed in large quantities into activated carbon.
– Activated carbon (a derivative of charcoal) of various grades is used in the field of water treatment; for cleaning technical liquids; alcohol and sugar in food production; distillate from impurities; air from toxins and unpleasant odors; in various filtering installations, gas masks; a 3m carbon filter or other type is often used in face shields.
– BAU activated carbon is widely used in medicine as a gastric sorbent, for heartburn, gastritis, poisoning and indigestion.
– Food additive – dye E153.
– Specially fired sticks are used by artists for drawing. There are also pencils with compressed charcoal leads.
– As an additive to the earth to improve its hygroscopicity. It is sometimes used as a cure for indoor plant diseases.
– For polishing and grinding parts in printing and instrument making.
– Alder wood charcoal is needed to produce quick-burning black powder.
– Goes to the manufacture of electro-carbon parts for electrical equipment, electric motors.
– Included in charcoal animal feed.
– Insulating material in construction to absorb moisture and odors.
– In the absence of an alternative, it can be used as a fuel for automotive engines.

In the chemical store of Prime Chemicals Group you can buy BAU charcoal – birch activated charcoal at good prices. The range also includes chemical reagents and protective equipment, including a 3m carbon filter.