Recommended Activated Charcoal Dosing for Phenol Poisoning
For phenol poisoning, activated charcoal should be administered at a dose of 1-2 g/kg body weight orally or via nasogastric tube, with 50g being the standard adult dose. 1, 2
Administration Guidelines
- Activated charcoal should be administered as soon as possible after phenol ingestion, ideally within the first hour when it is most effective 3
- For adults, a standard dose of 50g is recommended, while children should receive 1 g/kg body weight 4, 5
- Administration should only occur in patients with an intact airway or after airway protection has been established to prevent aspiration 5, 3
- Immediate administration via small bore nasogastric tube is recommended in phenol poisoning cases 2
Important Considerations for Phenol Poisoning
- Avoid inducing emesis, administering alcohol, or oral mineral oil as these may increase phenol absorption 2
- Gastric lavage is generally not recommended for phenol poisoning 2
- Activated charcoal should be administered along with olive oil via nasogastric tube in cases of phenol ingestion 2
- For dermal phenol exposure, immediate decontamination with copious amounts of water followed by undiluted polyethylene glycol is necessary before considering activated charcoal for any ingested amount 2
Multiple Dose Considerations
- Repeated doses of activated charcoal (20-50g every 4-6 hours) may be beneficial in severe phenol poisoning until clinical improvement is observed 4
- Multiple-dose activated charcoal should only be administered under medical supervision 6
- Formulations containing sorbitol as a cathartic should be used cautiously, as hypernatremic dehydration has been reported after repeated doses 1
Limitations and Contraindications
- Activated charcoal is contraindicated in patients with impaired consciousness without airway protection due to aspiration risk 5
- The American Heart Association and American Red Cross state there is insufficient evidence to recommend for or against activated charcoal in first aid settings 7, 6
- Always contact poison control centers for guidance before attempting any decontamination method 6
- Activated charcoal should not be administered by lay rescuers without direction from poison control or emergency medical personnel 6
Efficacy Considerations
- The effectiveness of activated charcoal decreases significantly with time after ingestion, with mean reduction in absorption decreasing from 47.3% at 30 minutes to 21.13% at 180 minutes post-ingestion 3
- Activated charcoal is a safe, effective, and inexpensive alternative to more invasive treatments for phenol poisoning when administered properly 8
- Always prioritize airway protection and hemodynamic stabilization before considering gastrointestinal decontamination 6