Activated charcoal is indicated for poisoning in which patient condition?

• A. Unconscious patient
• B. Alert patient
• C. Pediatric patient with dehydration
• D. Suspected cyanide poisoning

Answer: (B)

Activated charcoal works by adsorbing many ingested toxins in the GI tract, reducing how much poison enters the bloodstream. Because it can cause vomiting and aspiration, it must be given only when the patient can protect their airway and swallow safely.

An unconscious patient cannot reliably protect their airway, so charcoal is not given unless the airway has been secured (for example, with intubation). That airway risk makes the unconscious scenario inappropriate for charcoal administration.

Charcoal also isn’t a treatment for all poisons. It does not bind cyanide effectively, so suspected cyanide poisoning isn’t an indication for charcoal.

A pediatric patient with dehydration isn’t a definitive indication by itself; the key factors are whether the patient can protect the airway and whether the toxin is one that charcoal can adsorb. Therefore, an alert patient who can protect their airway is the scenario where activated charcoal is appropriate.