To Decontaminate or Not to Decontaminate? The Balance Between Potential Risks and Foreseeable Benefits

The various techniques that can be used to achieve gastrointestinal decontamination have been reviewed in position statements sponsored by the American Academy of Clinical Toxicology and the European Association of Poison Centres and Clinical Toxicologists. Although the indications have been presented, clinicians still have some latitude as to whether they should use them or not in a particular case. The aim of this article is to present an approach that clinicians may use to help them decide to decontaminate a patient or not after an oral exposure. After a review of the position statements, we will discuss how the risk assessment of the exposure can be made and suggest an approach, the gastrointestinal triangle, to balance the potential risks against the foreseeable benefits of decontamination. (C) 2008 Elsevier Inc. All rights reserved.