[e-drug] Paracetamol poisoning

[Beverley Snell <bev@burnet.edu.au>]

E-drug: Paracetamol poisoning
---------------------------------------------

In response to Peter Lurie's contribution concerning dangers with
paracetamol (acetaminophen in USA) I am sharing these training notes
we have used for health workers in community heath centres in 
Victoria, Australia.

The Royal Children's Hospital (RCH) statistics indicate that
paracetamol syrup is responsible for most poisoning admissions in the
hospital.  Children usually find the syrup bottle themselves, and
drink straight from the bottle.  In consultation with people from the 
RCH, we devised the following training for health workers.

Paracetamol:
Overdose  -  1g in a 1 yr old
a serious overdose

One 100 mL bottle of 120 mg/ 5 mL syrup contains 2.4g paracetamol.
1/3 bottle =  overdose for a 1 yr old.
More would be more serious in a one year old child
The whole bottle would be an overdose for a much older child.
The maximum dose for a 25 kg child would be 1g.
Policy:
Repack bigger bottles into bottles that contain only 30 mL of the syrup.
Child resistant caps will always be used.
Each time paracetamol is supplied to a mother, she should be warned
of the dangers to children and reminded that it should be kept out of
reach of children.
Paracetamol syrup should be dispensed only in enough quantity for the
immediate needs of a child.  Several bottles for ongoing use must not
be supplied.
-- 

Beverley Snell
Centre for International Health
Macfarlane Burnet Institute for Medical Research & Public Health
GPO Box 2284, Melbourne 3001 Australia

Telephone 613 9282 2115 / 9282 2275
Fax 61 3 9282 2144  or  9282 2100
email <bev@burnet.edu.au>
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