Drug Safety Update
December 2014: Treating paracetamol overdose with intravenous acetylcysteine: new guidance
January 2017: Intravenous N-acetylcysteine (NAC) for paracetamol overdose: reminder of authorised dose regimen; possible need for continued treatment with NAC.
January 2018: Co-dydramol: prescribe and dispense by strength to minimise risk of medication error.
NICE CKS (Clinical Knowledge Summaries) Analgesia - management of mild to moderate pain September 2015
Paracetamol has similar efficacy to aspirin but has no anti-inflammatory effect and does not cause gastritis/gastric uleration.
Paracetamol injection is available for post-operative pain in selected patients only where the oral route cannot be used.
MTW NHS Trust Protocol for the use of intravenous paracetamol updated 2019
Royal College of Emergency Medicine (RCEM) Paracetamol overdose new guidance on the use of intravenous acetylcysteine.
A new weight-based dosing table and a technical information leaflet to help calculate the dose of acetylcysteine infusions to minimise the risk of dosing errors are available to download
Methoxyflurane is approved for use within the Emergency Department ONLY for the emergency relief of moderate to severe pain in conscious adults patients with trauma and associated pain, where they would otherwise require procedural sedation.
Please see eMC via link below to access the risk materials associated with this treatment (admin checklist and guide) . The Procedural Penthrox Checklist produced by MTW ED should also be used. Methoxyflurane should only be self-administered under the supervision of personnel trained and experienced in its use, using a hand-held Penthrox inhaler device. Patients should be given advice on appropriate inhaler technique and given a patient alert card (found via eMC link).