This week I travelled to one of the busiest emergency departments in the state, where I chatted to emergency consultant Daniel Gaetani. Daniel is an emergency doctor with a love for toxicology and all things ultrasound. This episode we unpacked the new paracetamol overdoses guidelines. 

We talked through four real cases and discussed indications for NAC infusions. The episode included pharmacokinetics of Panadol and how different formulations can affect our patients. We discussed the

rumack-matthews nomogram, LFTS , Panadol levels and even phosphate. Daniel gave us insight into when you should call toxicology and when to refer to transplant teams. We also went through how Daniel is using ultrasound in his Emergency department and where he envisions it being used in the future. 

Please see links below for all content used on this episode. 

Paracetamol Specific Resources

Chiew, A. et al. (2020). ‘Updated Guidelines for Management of Paracetamol Poisoning in Australian and New Zealand.’ Medical Journal of Australia 212(4): 175 – 183.

Katzung & Trevor’s Basic and Clinical Pharmacology 14th Edition Section VI: Drugs used to treat diseases of the blood, inflammation and gout

Life in the Fastlane (2020). ‘Paracetamol Toxicity.’ Accessed July 2020.

Murray, L. et al. (2015). ‘Toxicology Handbook, 3rd edition: Chapters 3.60 Paracetamol: Acute overdose, 3.61 Paracetamol: Modified-release formulation and 3.62 Paracetamol: Repeated supratherapeutic ingestion.’ Churchill Livingstone, Australia.

Murray, L. et al. (2015). ‘Toxicology Handbook, 3rd edition: Chapters 3.60 Paracetamol: Acute overdose, 3.61 Paracetamol: Modified-release formulation  and 3.62 Paracetamol: Repeated supratherapeutic ingestion.’ Churchill Livingstone, Australia.

General Toxicology Resources

Murray, L. et al. (2015). ‘Toxicology Handbook, 3rd edition.' Churchill Livingstone, Australia. 

Local Policies and Procedures.

NSW Poisons Information Centre 13 11 26.

Case Notes Below 

https://docs.google.com/presentation/d/1BEws0s6CeAw-zG1jhumbIH6Kd5qVKuzD8bvbvglD8yo/mobilepresent?slide=id.g8dad0fe5d3_0_25