title: Impact of new UK paracetamol overdose guidelines on patients presenting to the emergency department.
abstract: Paracetamol is involved in a large proportion of overdoses that present to the Emergency Department (ED), either as lone or mixed overdoses. Non-treatment of toxic levels can lead to fulminant liver failure. This study is to determine the impact the new UK treatment guidelines will have on patients presenting with paracetamol overdose. A retrospective review was performed on all patients who had paracetamol levels done in the ED between September 2011 and August 2012. A total of 523 patients were identified, 95 (18%) of whom had detectable paracetamol levels. 74 patients from the 95 were evaluated. 18 (24%) patients were treated with N-acetylcysteine as per the then paracetamol overdose guidelines. Using the new guidelines would have resulted in 3 more patients being admitted. Our study shows that most patients who present following paracetamol overdose do not require treatment with N-acetylcysteine and suggests that the introduction of the new UK treatment guidelines is likely to result in only a small increase in the number of patients requiring treatment.
authors.forename: G
authors.initials: G
authors.lastname: Nfila
authors.forename: S
authors.initials: S
authors.lastname: Lee
authors.forename: J
authors.initials: J
authors.lastname: Binchy
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000506:poisoning*; D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000506:poisoning; D062787:Drug Overdose / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen