Paracetamol overdose in patients under 16 years old

SJH Emergency Medicine
NHS Lothian

Objectives

To guide the management of patients younger than 16 years, who have taken an overdose of paracetamol

Scope

Patient less than 16 years who have ingested an excess of paracetamol

Audience

All clinical staff in NHS Lothian managing children and young people with paracetamol overdose

Paediatric paracetamol overdoses are treated using different (but similar) pathways to adult paracetamol overdoses. These are also based on the SNAP protocols. For under 16s please use the protocols below:

Editorial Information

Last reviewed: 13/08/2024

Next review date: 13/08/2026

Author(s): David Cairney (ST5 Paediatrics), Jen Browning (Emergency Medicine Consultant), James Dear (Consultant Toxicologist).

Reviewer name(s): Alexis Leal, Beth Walsh, Deepankar Datta.

Related resources

Based on protocols agreed between NHS Lothian CYP and toxicology teams

Evidence method
  1. NHS Lothian Adult Multidisciplinary Care Pathway for Paracetamol Overdose - therapeutic excess
  2. Toxbase - Paracetamol Overdose
  3. Management of paracetamol overdose in patients LESS THAN 40kg (adults and paediatrics) - Guy's and St Thomas' Clinical Guideline (Prof Paul Dargan)
  4. Pettie JM, Caparrotta TM, Hunter RW, Morrison EE, Wood DM, Dargan PI, Thanacoody RH, Thomas SHL, Elamin MEMO, Francis B, Webb DJ, Sandilands EA, Eddleston M, Dear JW. Safety and Efficacy of the SNAP 12-hour Acetylcysteine Regimen for the Treatment of Paracetamol Overdose. EClinicalMedicine. 2019 May 2;11:11-17. doi: 10.1016/j.eclinm.2019.04.005. PMID: 31317129; PMCID: PMC6610779.
  5. Bateman DN, Dear JW, Thanacoody HK, Thomas SH, Eddleston M, Sandilands EA, Coyle J, Cooper JG, Rodriguez A, Butcher I, Lewis SC, Vliegenthart AD, Veiraiah A, Webb DJ, Gray A. Reduction of adverse effects from intravenous acetylcysteine treatment for paracetamol poisoning: a randomised controlled trial. Lancet. 2014 Feb 22;383(9918):697-704. doi: 10.1016/S0140-6736(13)62062-0. Epub 2013 Nov 28. Erratum in: Lancet. 2016 May 7;387(10031):1908. doi: 10.1016/S0140-6736(16)30423-8. PMID: 24290406.