 |
 |
BAEM have produced draft guidelines for quality issues in A&E. One of these is giving charcoal to patients attending within one hour of arriving in A&E after a paracetamol overdose. Most attend after 1 hour. I'm a little suspect about this marker for an excellent service and yes I'm aware of http://www.bestbets.org/cgi-bin/bets.pl?record=00059 , but there is a proven antidote for paracetamol poisoning. Why not give methionine 2.5 gm (10 tablets) orally if the patient attends within 1 hour? It's easier to get down than 50 gm of charcoal and doesn't cost as much. Also traditional teaching is that you give 5 to 10 times the amount of charcoal compared to drug. Perhaps this is another study for some keen registrar to do? Ray McGlone A&E Consultant Royal Lancaster Infirmary / Westmorland General Hospital http://www.mbha.nhs.uk/morecambe_bay_hospitals_trust.htm