If someone has swallowed something poisonous, call the Poison Help line at 1-800-222-1222 immediately. You’ll reach nurses, pharmacists, and doctors available 24 hours a day, 7 days a week, who can tell you exactly what to do based on the specific substance. If the person is unconscious, having seizures, or struggling to breathe, call 911 instead. The method used to remove or neutralize a poison depends entirely on what was swallowed, how much, and how long ago.
Why You Should Not Induce Vomiting
The most common instinct is to make the person throw up. This is almost always the wrong move. Ipecac syrup, once a medicine cabinet staple, is no longer recommended by poison control centers for home use. Here’s why: if someone swallowed a corrosive substance like drain cleaner, lye, or a strong acid, vomiting forces that chemical back through the throat and esophagus a second time, causing additional burns. If they swallowed a petroleum product like gasoline, kerosene, or paint thinner, vomiting can send droplets into the lungs and cause a severe form of pneumonia.
Vomiting also poses serious risks for anyone who is drowsy, confused, or losing consciousness. The vomited material can enter the airways, and infants and young children are especially vulnerable to choking on their own vomit. When too much ipecac is used, it can damage the heart muscle and other organs, potentially causing death. The bottom line: do not try to force vomiting unless a poison control professional specifically instructs you to do so for that exact substance.
Activated Charcoal: The Most Common Hospital Treatment
Activated charcoal is the first-line treatment for many types of poisoning. It works by binding to the toxin inside the stomach and intestines, trapping it so the body can’t absorb it into the bloodstream. The charcoal passes through the digestive system and carries the poison out with it. It’s not the same as charcoal briquettes. Medical-grade activated charcoal is processed to have an enormous surface area covered in tiny pores that grab onto dissolved chemicals.
Timing matters enormously. Activated charcoal is most effective when given within about 60 minutes of swallowing the poison. After that window, much of the toxin has already moved deeper into the intestines or entered the bloodstream, and charcoal becomes far less useful. A typical adult dose is 50 to 100 grams mixed into a liquid, usually given as a single dose. Children ages 2 to 12 receive 25 to 50 grams, and infants under one year get 10 to 25 grams.
Charcoal doesn’t work on everything. It binds best to organic chemicals that don’t dissolve easily in water. It’s poor at trapping metals like iron or lithium, alcohols, acids, and alkalis. For those substances, other methods are needed. In some poisoning cases involving sustained-release medications, doctors give repeated smaller doses of charcoal (10 to 25 grams every 2 to 4 hours) to keep catching toxin as it slowly releases.
Gastric Lavage (Stomach Pumping)
Gastric lavage is what most people picture when they think of “getting your stomach pumped.” A large tube is passed through the mouth into the stomach, and fluid is flushed in and suctioned back out repeatedly to wash out the contents. It sounds aggressive because it is. Current medical guidelines are very specific about when it’s appropriate: only when someone has swallowed a potentially life-threatening amount of poison and the procedure can be performed within 60 minutes of ingestion.
Outside that narrow window, studies show lavage doesn’t recover enough poison to justify the risks. Those risks include aspiration, where stomach contents get pulled into the lungs. As little as 50 milliliters of regurgitated material (a few tablespoons) entering the lungs can cause severe pneumonia or respiratory failure. Lavage is never performed on someone who has swallowed a corrosive substance, since the tube could perforate damaged tissue in the esophagus. It’s also not used for petroleum-based products because of the aspiration danger. The patient typically needs to be conscious with functioning protective reflexes, or already on a breathing tube.
Whole Bowel Irrigation
When the poison has moved past the stomach or when activated charcoal won’t bind to it, doctors sometimes use whole bowel irrigation. This involves pumping a large volume of a balanced electrolyte solution (the same type used for colonoscopy prep) through a tube in the nose or mouth, straight into the stomach, at a steady rate. The solution flushes through the entire digestive tract and pushes the toxic material out the other end. It continues until what comes out looks as clear as what went in.
This method is most commonly used for iron tablet overdoses, sustained-release medications like certain heart and blood pressure drugs, lithium, and packets of swallowed street drugs like heroin or cocaine. It’s also used when someone has swallowed small metal objects or lead-based paint chips. The solution itself isn’t absorbed by the body, so it doesn’t cause dangerous shifts in fluid or electrolyte levels. It’s considered safe even in pregnant women and young children, though the process is unpleasant and can take hours.
Endoscopy for Dangerous Objects
Some swallowed items need to be physically pulled out. Button batteries are the most urgent example. A button battery lodged in the esophagus or stomach can cause severe chemical burns within hours as it leaks alkaline material. Doctors use an endoscope, a thin flexible tube with a camera and small tools on the end, to locate and retrieve the battery using a net or basket attachment. This is treated as an emergency procedure.
Endoscopy is not used for drug packets, however. Grabbing a bag of cocaine or heroin with endoscopic tools risks puncturing it, which could release a lethal dose directly into the body. For swallowed drug packets, whole bowel irrigation or surgery are the safer options.
Why Corrosive Poisons Are Treated Differently
Acids and alkalis like bleach, drain cleaner, and oven cleaner cause direct chemical burns to tissue on contact. Every standard removal technique carries extra danger with these substances. Vomiting re-exposes the esophagus and throat to the chemical. Gastric lavage risks perforating tissue that’s already been weakened by burns. Even placing a tube blindly through the esophagus can cause a perforation or introduce infection. If a tube is needed, it’s placed under direct visual guidance using an endoscope so doctors can see the extent of the damage and avoid pushing through weakened tissue.
Activated charcoal is also not useful for corrosives. The priority with these ingestions shifts from removing the substance to assessing the damage it has already caused and preventing complications like infection, perforation, or scarring that can narrow the esophagus over time.
What to Do Before Help Arrives
While waiting for guidance from poison control or emergency services, a few things genuinely help. Keep the person calm and upright if they’re conscious. Try to identify exactly what was swallowed, how much, and when. If you have the container, keep it nearby so you can read the label to the poison control specialist. Don’t give the person anything to eat or drink unless specifically told to by a professional, and don’t try any home remedies like milk, saltwater, or raw eggs.
If the substance got on the skin or in the eyes, rinse with plain water for at least 15 to 20 minutes. If the person vomits on their own, turn them on their side to keep the airway clear, and save a sample of the vomit if you can, since it may help identify the toxin at the hospital. The single most important step is making that call to 1-800-222-1222. The professionals on the other end handle these situations every day and will walk you through exactly what to do for the specific poison involved.