The first line of response for people who self-poison: exploring the options for gut decontamination.

The trend for increasing numbers of self-poisoning incidents has been noted and a variety of policy initiatives have been launched. Nurses, particularly in emergency room environments occupy a pivotal place in the chain of response to such acts. Any such response needs to be firmly rooted in evidence-based practice yet the initial management of self-poisoning often involves a consideration of procedures, the application of which can vary enormously. This paper offers some contextual information prior to a critical perspective of management modes, namely emesis, lavage, the use of activated charcoal and whole bowel irrigation. A comparison of the relative advantages and disadvantages of each mode precedes suggestions for nursing practice.