• Andis Graudins.
• Monash Health Clinical Toxicology and Addiction Medicine Service, Monash Emergency Medicine Program, Monash Dandenong Hospital, Monash Health, Melbourne, Victoria, Australia; School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
• Emerg Med Australas. 2015 Apr 1;27(2):139-44.

ObjectiveTo describe and compare the characteristics of paracetamol poisoning in adolescent and adult patients.MethodDescriptive retrospective case series of adolescent (12-17 years) and adult (>18 years) patients presenting to a metropolitan hospital network ED, diagnosed with paracetamol poisoning from October 2009 to September 2013.ResultsThere were 220 adolescent (median age 16 years, 47% treated with acetylcysteine [NAC]) and 647 adult presentations (median age 27 years, 42% treated with NAC) for paracetamol poisoning in the study period. Adolescent patients were more frequently women (89% vs 76%; odds ratio [OR] 2.4; 95% confidence interval [CI] 1.5-3.8) and ingested similar amounts of paracetamol (18 g) when requiring NAC treatment. Adolescents were more likely to ingest paracetamol as a single agent (53% vs 34%; OR 2.2; 95% CI 1.6-3.0) and less likely to ingest compound paracetamol products than adults (18% vs 29%; OR 0.54; 95% CI 0.36-0.79). Adolescents were less likely to report accidental supratherapeutic ingestion of paracetamol (0.02% vs 10%; OR 0.23; 95% CI 0.09-0.58), or co-ingestion of prescription medications (25% vs 43%; OR 0.4; 95% CI 0.31-0.62). Adolescents had more frequent histamine release reactions to NAC than adults (17% vs 8%; OR 2.3; 95% CI 1.2-4.5). No cases required liver transplantation or resulted in death.ConclusionAdolescents ingested comparable amounts of paracetamol to adults, when presenting with deliberate self-poisoning. However, there were significant differences in co-ingested medications and the reason for ingestion of paracetamol. Histamine reactions to NAC were more common in adolescents; however, most were mild. Overall, outcome was favourable in both cohorts.© 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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