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Paracetamol poisoning in the North East of England: presentation, early management and outcome

Wolfson Unit of Clinical Pharmacology, University of Newcastle upon Tyne, Newcastle NE2 4HH

JE Horner

Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE9 6SX

K. Chew

Newcastle General Hospital, Westgate Rd, Newcastle NE4 6BE

J. Connolly

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ

B. Dorani

Newcastle General Hospital, Westgate Rd, Newcastle NE4 6BE

L. Bevan

Sunderland District General Hospital, Kayll Rd, Sunderland SR4 7TP

S. Bhattacharyya

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ

MG Bramble

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ

KH Han

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ

A. Rodgers

Dryburn Hospital, North Road, Durham DH1 5TW

B. Sen

Royal Victoria Infirmary, Queen Victoria Road, Newcastle NE1 4LP, UK

B. Tesfayohannes

Sunderland District General Hospital, Kayll Rd, Sunderland SR4 7TP

H. Wynne

Royal Victoria Infirmary, Queen Victoria Road, Newcastle NE1 4LP, UK

DN Bateman

Wolfson Unit of Clinical Pharmacology, University of Newcastle upon Tyne, Newcastle NE2 4HH

1 Paracetamol is increasingly involved in self-poisoning in the United Kingdom and remains a common cause of fatal poisoning.

2 To document the epidemiology and early management of paracetamol poisoning data were collected on consecutive patients with suspected paracetamol poisoning presenting to 6 hospitals in the North East of England over 12 weeks in 1994.

3 There were 400 presentations (attendance rate 1.14/10³ population/yr) involving 343 persons (45% male). Paracetamol concentrations at 4 h correlated weakly with reported paracetamol dose (R=0.49, P < 0.0001) and were similar comparing those treated and not treated by gastric decontamination.

4 In 38 (9%) cases paracetamol concentrations were above the appropriate nomogram treatment line, including 3% and 20% of patients who reported ingesting less than and more than 12 g respectively. In 21 patients acetylcysteine treatment was deferred until admission to the ward, the mean delay involved was 2.8 h.

5 One patient died, from arrhythmias caused by co- ingested dothiepin.

6 Paracetamol poisoning is common. Most cases do not have potentially toxic plasma paracetamol concentra tions, but those who do often present late and antidotal treatment may be delayed inappropriately.

Key Words: poisoning • epidemiology • paracetamol • acetamino phen • charcoal

Human & Experimental Toxicology, Vol. 16, No. 9, 495-500 (1997)
DOI: 10.1177/096032719701600903


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