What is the recommended timeframe for gastric decontamination by emesis or lavage after ingestion?

• A. Within 24 hours of ingestion
• B. Within 6 hours of ingestion
• C. ≤1 hour
• D. Only with physician approval

Answer: (C)

Gastric decontamination is only worthwhile when the toxin is still in the stomach and not yet absorbed. Emesis and gastric lavage carry notable risks, especially aspiration and injury, and their benefit declines rapidly as time passes because most substances move into the small intestine or are already absorbed. Therefore, the recommended window for attempting gastric decontamination is within one hour of ingestion. After that, the potential harms outweigh the benefits, so these procedures are not routinely performed. In practice, such decontamination is reserved for very select, life-threatening ingestions and is done with careful airway protection and appropriate indications.