Which one of the following interventions is CONTRAINDICATED during emergency-department management of a patient who has aspirated a caustic alkali after intentional ingestion?
Secure the airway and perform rapid-sequence intubation if airway edema is developing.
Keep the patient NPO and arrange for early upper endoscopy (within 24 hours).
Administer single-dose activated charcoal orally to bind the caustic substance.
Contact the regional poison control center for further management guidance.
Activated charcoal should be avoided because strong acids and alkalis are poorly adsorbed, the agent obscures mucosal visualization needed for early endoscopy, and it may precipitate vomiting or further aspiration. Appropriate management includes securing the airway, keeping the patient NPO with early endoscopic evaluation, and consulting a regional poison control center.
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