Expert Opinions

Michael Heller MD

Department of Emergency Medicine Beth Israel Medical Center New York, New York Professor, Clinical Emergency Medicine Albert Einstein School of Medicine Bronx, New York

November 30, 2013

 

Dear Dr. Stang,

Thank you for soliciting my thoughts on the activated charcoal cookie concept. I remember seeing (and tasting) a prototype several years ago.

The advantages of the product will no doubt be evident to those of us engaged in the daily practice of Emergency Medicine and perhaps to parents of young children as well. Although many children readily ingest the liquid preparations of charcoal in water or sorbitol, virtually all children will eagerly accept a product that simulates a cookie. I suspect that ED staff would favor a cookie-like product over the currently used slurry which is by nature inconvenient and prone to staining most everything in the department.

In may be that its greatest application would be in the home cabinet and ambulance. For a parent, its familiar, non- threatening form would allow for easy and safe home administration. For the EMS provider, the slurry form of charcoal has always been problematic as it is likely to make a mess in the back of a moving ambulance where spillage and soiling of the unit is almost inevitable.

Although the role of activated charcoal in the routine treatment of poisonings has been questioned in recent years, much of the concern is attributable to two factors: most childhood poisonings are benign, even without treatment and the use of the agent is often delayed by many minutes or hours thus limiting any possible efficacy. If- as I believe it would- shorten the interval to treatment by allowing for earlier administration, ideally at home or in the pre-hospital phase, the cookie would represent a welcome tool in the arsenal in our continued efforts to meet the challenge of pediatric poisonings.

Sincerely,

Michael Heller

Michael Heller MD - Department of Emergency Medicine Beth Israel Medical Center New York, New York Professor, Clinical Emergency Medicine Albert Einstein School of Medicine Bronx, New York