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

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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.