If Charcoal Makes You Choke ...

Try chocolate or Coke, says new study

TUESDAY, July 10 (HealthDayNews) - Even the nastiest medicine seem to go down better with a little help from two of America's favorite flavors.

One evil-tasting remedy -- activated charcoal, the substance kids who've swallowed something poisonous must drink to get rid of the toxin -- becomes considerably more palatable when mixed with either chocolate milk or Coca-Cola, says a new study.

"Activated charcoal is the primary agent that is used nowadays ... because that absorbs the toxin, whatever thing they overdosed on, from the stomach before it can enter the bloodstream," says lead researcher Dr. Elisabeth Skokan, an assistant professor of pediatrics at the University of Utah School of Medicine.

But she says taking charcoal is "like eating dirt," and the kids have to consume a lot of the "thick, gritty black substance" to absorb the poisons. Kids who can't drink the charcoal have a tube inserted through the nose to the stomach to deliver it directly.

"It's not an option for them to just not take it," and the tubes make an already traumatic situation even more so, with kids screaming and parents becoming upset, Skokan says.

Masking the taste lessens the trauma and lets the substance slide into the stomach much more easily, without diminishing the power of the activated charcoal, she says.

Chocolate milk and Coke were chosen for the emergency department of the Utah university's medical center based on taste tests conducted by Skokan and her colleagues at a bicycle safety booth at a fair in Salt Lake City.

Participants tasted five substances -- charcoal alone and charcoal mixed with chocolate milk, Coke, cherry-flavored syrup and sorbitol, a rice-based sweetener.

Of 53 volunteers, ages 3 to 17, kids younger than 8 rated the tastes on what the researchers call a face scale: a range of expressions from a big, smiley face to a really unhappy, frowning face, complete with tears. The older kids rated tastes on a scale of 0 to 100 and judged how easy or difficult the mixture was to swallow. Participants got a little water bottle after the tests for their efforts, Skokan says.

Chocolate milk came out on top, favored by 39 percent of the kids as the single-best flavoring agent, she says. Coke and cherry-flavored syrup followed, each with roughly 23 percent. Details appear in last month's issue of the Archives of Pediatric & Adolescent Medicine.

"As a result of this study, in our emergency department they only offer activated charcoal with chocolate milk or Coca-Cola now," Skokan says. "It's so much easier, and the nurses are thrilled, really really thrilled with this study."

"Kids seem to be drinking it much better. In fact, the nurses refuse to even try [to give] it plain any more," Skokan says.

Adding popular flavorings "seems to have dramatically reduced the number of nasal-gastric tubes we've had to use," Skokan says. While that observation is based on anecdotal evidence rather than hard data, she says it's clear that the flavorings have "really improved everything about giving activated charcoal, which is a nasty thing to have to give."

That's not surprising to those who tout those tastes as America's favorites.

"Colas tend to have a rich complex flavor, and Coke, of course, is the standard in authentic, great-tasting colas," says Mart Martin, a Coca-Cola Company spokesman.

Susan Fussell, a spokeswoman for the Chocolate Manufacturers Association, says chocolate is "a flavor that people seek. There's nothing that tastes like chocolate, and most people love chocolate," she says.

"Chocolate has a lot of the properties of a comfort food. Maybe there's something psychological going on there, as well," Fussell says.

What To Do

For more about poison prevention, visit the Food and Drug Administration online.

Or, check information provided by the University of Maine Cooperative Extension Service or the Centers for Disease Control and Prevention.

Or, if Coke isn't your cup of tea, take the Pepsi challenge.

SOURCES: Interviews with Elisabeth Skokan, M.D., M.P.H., assistant professor, Division of Pediatric Emergency Medicine, Department of Pediatrics, Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City; Mart Martin, spokesman, Coca-Cola Company, Atlanta; Susan Fussell, communications manager, Chocolate Manufacturers Association, Vienna, Va.; June 2001 Archives of Pediatric & Adolescent Medicine
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