Panadol Osteo®, Duatrol SR®) cannot be interpreted using the nomogram, and advice should be sought from the Poisons Information Service 13 11 26 or local toxicology services. Supra-therapeutic overdoses of >60mg/kg/day in children (>4g/day in adults), or those involving modified release preparations (e.g.This guideline will cover single overdoses, or staggered ingestions over a period of less than 8 hours of the immediate-release preparation of paracetamol.N-Acetyl Cysteine (acetylcysteine) is an effective and well-tolerated antidote and if given within 8 hours of ingestion, is almost 100% effective at preventing liver injury.Morbidity and mortality is from hepatic injury.Paracetamol overdose can occur as either a single large ingestion, usually as a deliberate self-poisoning, or as an accidental supra-therapeutic ingestion over days. Specific information about poisoning presentations can be obtained from Poisons Information Service 13 11 26 or refer to the Toxicology Handbook. This guideline provides an outline of the general approach to paracetamol poisoning. To guide staff with the assessment and management of paracetamol poisoning in children. R ead the full PCH Emergency Department disclaimer. Clinicians should also consider the local skill level available and their local area policies before following any guideline. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient.

Clinical common-sense should be applied at all times. They are not strict protocols, and they do not replace the judgement of a senior clinician. These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital.

Paracetamol antidote