Can you tell me about benzodiazepine overdose and how to reverse it? I'm finding conflicting information on whether to use activated charcoal and whether to use the benzo overdose antidote, Flumazenil.
Also say the whumpee is coding from the overdose. Would that change the opinion of the doctors on whether to use activated charcoal or Flumazenil? I would assume it might change things to more of a "we have nothing to lose" opinion if the patient is already clinically dead.
Thanks! Your blog is one of the most valuable resources on the internet for whump research.
The reason you may have gotten conflicting information is because it really depends on a lot of factors.
First, activated charcoal generally only works if given within about an hour of ingestion of the toxic substance, in this case the benzidiazepine. It's also a whole thing, where 50-100g of activated charcoal powder is mixed with about a liter of water or cola. The patient then either has to drink it (usually fairly quickly) or else get a tube going from their nose to their stomach and have it administered that way. So it's not really a "code friendly" medication. Also, I was only able to find one study suggesting activated charcoal works on benzodiazepines (It doesn't work on everything).
Flumazenil is a decent drug, but it works best on people who haven't taken a benzodiazepine long-term. This is because, in people with a tolerance to benzodiazepines, it sends people from overdose to severe withdrawal in a matter of minutes, and benzodiazepine withdrawal is life-threatening due to the high risk of repeated seizures (flumazenil also causes seizures, so there are risks). Obviously it's going to be given since it's the only option, and there are ways to manage seizures without benzodiazepines, but still, if it weren't for your character coding, there would be pause.
So basically, if he were at the point of coding, they'd give flumazenil, because it would probably be too late for the activated charcoal.
