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

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.