New Acetaminophen Poisoning Guidelines from the Royal College of EM

Link to Full Guideline

The key changes from previous guidance are:

  • A single treatment line regardless of hepatotoxicity risk
  • The duration of administration of the first dose of intravenous acetylcysteine is increased from 15 minutes to 1 hour.
  • Removal of hypersensitivity as a contraindication to treatment with acetylcysteine.
  • Provision of weight-based dosing tables for adults and children.
  • A Technical Information Leaflet (TIL) which gives more detailed instructions on the preparation of acetylcysteine infusions

These changes are intended to simplify treatment decisions, minimise allergic reactions and reduce prescribing errors.  They reflect the findings of the Commission on Human Medicines that risk factor assessment was difficult and inconsistently applied in clinical practice. There have also been many reports of prescribing and administration errors.

Terminology Guide

Paracetamol = Acetaminophen = Tylenol



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