842 Multi-centre implementation of the SNAP Protocol for paracetamol overdose – fewer anaphylactoid reactions and shortened length of stay

Aims/Objectives/Background Paracetamol overdose is the most common drug in UK. The standard treatment of toxicity intravenous N-acetylcysteine (NAC) which usually given as a 21-hour infusion UK hospitals. A 12-hour known ‘SNAP’ regimen has been implemented some centres and appears on TOXBASE. SNAP associated with fewer anaphylactoid reactions than treatment. was initiated two District General Hospital Emergency Departments within same NHS Trust part quality improvement project (QIP) to determine whether inpatient length stay could be reduced. Methods/Design guidelines for were revised advising adults along pre-filled prescription chart. retrospective review patient notes electronic discharge letters performed before following new guideline identify patients who received NAC they suffered any adverse reactions. also recorded. Results/Conclusions In three months from August November 2020, across both sites, 60 adult overdose. Of these, four had NAC. Following introduction regimen, between April June 2021, 36 NAC, there no Prior chart admitted an average 48.3 hours compared 44.5 regimen. not more decreased inpatients Overdose.