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Journal of Accident & Emergency Medicine logoLink to Journal of Accident & Emergency Medicine
. 1998 Jan;15(1):13–17. doi: 10.1136/emj.15.1.13

The impact of nationally distributed guidelines on the management of paracetamol poisoning in accident and emergency departments. National Poison Information Service.

M C Bialas 1, R J Evans 1, A D Hutchings 1, G Alldridge 1, P A Routledge 1
PMCID: PMC1343000  PMID: 9475215

Abstract

OBJECTIVE: To assess the impact of the treatment guidelines on the management of paracetamol self poisoning in accident and emergency (A&E) departments. METHODS: 24 A&E departments in Wales and England provided details of their management of paracetamol poisoning before and after the distribution of national treatment guidelines to all A&E departments in the United Kingdom. RESULTS: Significant increases were seen in the availability of formal written policies, the display of treatment nomograms, the recommendation to treat beyond 16 hours after ingestion, and to use a lower line on the treatment nomogram for patients at special risk of paracetamol induced liver damage. CONCLUSIONS: Regularly updated guidelines in the management of paracetamol poisoning should be displayed in A&E departments so that medical and nursing personnel have access to the best current information on the treatment of poisoning with this frequently used drug.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bray G. P., Mowat C., Muir D. F., Tredger J. M., Williams R. The effect of chronic alcohol intake on prognosis and outcome in paracetamol overdose. Hum Exp Toxicol. 1991 Nov;10(6):435–438. doi: 10.1177/096032719101000612. [DOI] [PubMed] [Google Scholar]
  2. Buhl R., Jaffe H. A., Holroyd K. J., Wells F. B., Mastrangeli A., Saltini C., Cantin A. M., Crystal R. G. Systemic glutathione deficiency in symptom-free HIV-seropositive individuals. Lancet. 1989 Dec 2;2(8675):1294–1298. doi: 10.1016/s0140-6736(89)91909-0. [DOI] [PubMed] [Google Scholar]
  3. Douidar S. M., al-Khalil I., Habersang R. W. Severe hepatotoxicity, acute renal failure, and pancytopenia in a young child after repeated acetaminophen overdosing. Clin Pediatr (Phila) 1994 Jan;33(1):42–45. doi: 10.1177/000992289403300107. [DOI] [PubMed] [Google Scholar]
  4. Eriksson L. S., Broomé U., Kalin M., Lindholm M. Hepatotoxicity due to repeated intake of low doses of paracetamol. J Intern Med. 1992 May;231(5):567–570. doi: 10.1111/j.1365-2796.1992.tb00976.x. [DOI] [PubMed] [Google Scholar]
  5. Harrison P. M., Keays R., Bray G. P., Alexander G. J., Williams R. Improved outcome of paracetamol-induced fulminant hepatic failure by late administration of acetylcysteine. Lancet. 1990 Jun 30;335(8705):1572–1573. doi: 10.1016/0140-6736(90)91388-q. [DOI] [PubMed] [Google Scholar]
  6. Parker D., White J. P., Paton D., Routledge P. A. Safety of late acetylcysteine treatment in paracetamol poisoning. Hum Exp Toxicol. 1990 Jan;9(1):25–27. doi: 10.1177/096032719000900106. [DOI] [PubMed] [Google Scholar]
  7. Smith J. A., Hine I. D., Beck P., Routledge P. A. Paracetamol toxicity: is enzyme induction important? Hum Toxicol. 1986 Dec;5(6):383–385. doi: 10.1177/096032718600500610. [DOI] [PubMed] [Google Scholar]

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