Trends in emergency department use of gastric lavage for poisoning events in the United States, 1993–2003

Abstract

Objective. To determine current trends in the use of gastric decontamination for the emergency department (ED) treatment of overdose patients. Methods. In the National Health Ambulatory Medical Care Survey (NHAMCS), a weighted sampling of U.S. EDs, overdose-related visits were examined using ICD-9 CM E codes and NHAMCS' “reason-for-visit” classification. Results. From 1993 to 2003 there were an estimated 11.68 million ED-treated poisoning events. Some 13.7% of those treated were lavaged. Rates fell significantly, from an annual average of 18.7% of cases during 1993–97 to 10.3% during 1998–2003 (p < 0.001). Controlling for year, urgency, and admission status in multivariate logistic modeling, lavage was significantly and positively associated with private insurance payor status, younger age (<30), female gender, white race, 8 PM–8 AM presentation, and intentional rather than unintentional overdose. Conclusion. ED use of gastric lavage in poisoned patients has decreased significantly over the past decade but varies by demographic and non-clinical factors.

Keywords :

• Gastric lavage
• Poisoning
• Intentional overdose
• Decontamination trends
• NHAMCS