• María Codinach-Martín, Juan Ortega-Pérez, Maria Àngels Gispert-Ametller, Emilio Salgado-García, Amelia Rodríguez-Mariblanca, Santiago Nogué-Xarau, and Jordi Puiguriguer-Ferrando.
• Servicio de Urgencias, Hospital Doctor Josep Trueta, Girona, España.
• Emergencias. 2022 Jun 1; 34 (3): 190-195.

ObjectivesTo identify the most common problems related to use of N-acetylcysteine to reverse the toxic effects of paracetamol poisoning.Material And MethodsRetrospective descriptive observational study of clinical records for patients treated for paracetamol poisoning in 4 emergency departments during 3 years (2017-2019). We analyzed epidemiologic, clinical, and care variables, especially those related to the suitability and safety of using N-acetylcysteine as an antidote.ResultsWe included 332 cases of poisoning of 260 patients (78%) were over the age of 16 years, and 242 (73%) were female. Two hundred sixty-eight poisonings (81%) were the result of voluntary intake. The elimination half-life was determined in 20 cases (6%). Gastrointestinal decontamination was incorrectly prescribed on 39 occasions (28%). Treatment with the antidote was begun in 195 cases (58.7%). No serious clinical signs or symptoms were present in 282 cases (85%). The correlation of paracetamol levels in urine was stronger with the amount of drug ingested voluntarily (R2 = 0.23) than with accidental intake (R2 = 0.007). Predefined severity criteria were significantly related to reported dose ingested per body weight (P = .001) and the interval between intake and first medical assistance (P = .008).ConclusionEven though clear protocols are available to guide the use of antidote treatment in cases of paracetamol poisoning, variability in fundamental aspects of management is excessive.

16 keywords...

hide…