Ascendency of the black bottle (activated charcoal).

Previous well-established guidelines for the management of poisonous ingestions in children are undergoing significant change. The time-honored practice of syrup of ipecac-induced vomiting as the primary means of gastrointestinal decontamination now frequently yields to the administration of activated charcoal. Practitioners and emergency room physicians who are increasingly relying on advice from and participation in treatment by regional poison control centers need to understand the rationale behind what many consider contradictions to accepted teaching. A case in point was a recent letter to the American Academy of Pediatrics from a pediatrician questioning the treatment of an ingestion of poison in a toddler.