Thanacoody H K R, Good A M, Waring W S, Bateman D N
Scottish Poisons Information Bureau, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, UK.
Emerg Med J. 2008 Mar;25(3):140-3. doi: 10.1136/emj.2007.049015.
Paracetamol is the most common means of drug overdose in the UK. Guidance on management is available to junior doctors through TOXBASE, the online resource managed by the UK National Poisons Information Service (NPIS) and in poster form. TOXBASE is supported by NPIS units and further by a UK national rota of clinical toxicologists. A study was undertaken to examine reasons why calls about paracetamol are referred to consultants to better understand issues in managing this common poisoning.
Calls relating to paracetamol overdose referred by a poisons information specialist to the duty NPIS consultant between 1 May 2005 and 30 April 2006 were identified from the database and the number of TOXBASE accesses during the same time period was determined. Enquiries that resulted in consultant referral were classified into six categories.
Calls referred to NPIS consultants pertain mainly to patients who present late, staggered overdoses, adverse reactions to N-acetylcysteine, and interpretation of blood results. This information has been used to inform the development of TOXBASE so that comprehensive advice is readily available to end users.
The operation of a national consultant rota enables information on difficult or unusual cases of poisoning to be pooled so that treatment guidelines can be developed to optimise treatment throughout the UK.
对乙酰氨基酚是英国最常见的药物过量服用方式。初级医生可通过由英国国家毒物信息服务中心（NPIS）管理的在线资源TOXBASE以及海报形式获取管理指南。TOXBASE由NPIS各部门提供支持，并由英国临床毒理学家全国轮值表进一步提供支持。开展了一项研究，以探究关于对乙酰氨基酚的咨询为何会转介给顾问，从而更好地理解处理这种常见中毒情况时的问题。
从数据库中识别出2005年5月1日至2006年4月30日期间由毒物信息专家转介给值班NPIS顾问的与对乙酰氨基酚过量服用相关的咨询，并确定同一时期内TOXBASE的访问次数。导致转介给顾问的咨询被分为六类。
转介给NPIS顾问的咨询主要涉及就诊较晚的患者、分次过量服药、对N - 乙酰半胱氨酸的不良反应以及血液检测结果的解读。这些信息已被用于为TOXBASE的开发提供参考，以便终端用户能够随时获取全面的建议。
全国顾问轮值表的运作使得关于疑难或特殊中毒病例的信息得以汇总，从而能够制定治疗指南，以优化全英国的治疗。
