The impact of nationally distributed guidelines on the management of paracetamol poisoning in accident and emergency departments

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.