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

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.