Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison
CPT4 code
Name of the Procedure:
Ipecac Administration for Induced Emesis
Summary:
This procedure involves the intake of Ipecac syrup to induce vomiting in order to expel toxic substances from the stomach. The process is carefully monitored to ensure the stomach is adequately emptied of the poison.
Purpose:
Ipecac administration is used in cases of certain poisonings, typically when the ingested substance is likely to cause harm if absorbed into the bloodstream. The primary goal is to induce vomiting to help remove the toxin from the stomach before it can be absorbed by the body.
Indications:
- Recent ingestion of a toxic substance
- Situations where the poison is known to be effectively removed by emesis
- Conscious and alert patients capable of following instructions
Preparation:
- Confirm the type of poison ingested
- Ensure the patient has not ingested any substance for which emesis is contraindicated (e.g., caustics, hydrocarbons)
- Obtain a baseline assessment of the patient’s vital signs
Procedure Description:
- The patient is instructed to consume the recommended dose of Ipecac syrup, typically 15-30 mL.
- The patient is given 1-2 glasses of water to help induce vomiting.
- The patient is observed continuously for signs of effective emesis and for any adverse reactions.
- If vomiting does not occur within 20-30 minutes, a second dose may be administered as directed.
- Throughout the process, the patient’s vital signs and hydration status are monitored closely.
Duration:
The procedure typically takes about 30-45 minutes, including the monitoring period post-emesis.
Setting:
This procedure is generally performed in a hospital emergency room or an outpatient clinic that has the necessary resources for monitoring and managing potential complications.
Personnel:
- Emergency physician or pediatrician (depending on the patient's age)
- Nurses to assist with administration and monitoring
Risks and Complications:
- Aspiration of vomit
- Prolonged vomiting causing dehydration or electrolyte imbalances
- Potential ineffectiveness if the poison is rapidly absorbed
Benefits:
- Rapid removal of the toxic substance from the stomach
- Decreased risk of systemic absorption of the poison
- Reduced potential for more severe poisoning symptoms
Recovery:
- Patient is advised to rest and hydrate after the procedure.
- Clear liquids are recommended initially, progressing to a normal diet as tolerated.
- Some nausea may persist, but should subside relatively quickly.
- A follow-up appointment may be necessary to ensure no delayed complications occur.
Alternatives:
- Activated charcoal, which absorbs the toxin in the stomach
- Gastric lavage or stomach pumping in more severe cases
- Supportive care such as IV fluids and medications to manage symptoms
Patient Experience:
During the procedure, the patient will likely experience nausea and discomfort associated with vomiting. Following emesis, they may feel fatigued or weak. Pain management and comfort measures typically include hydration and resting in a comfortable position until fully recovered.