Gee P, Ardagh M
Emergency Department, Christchurch Hospital.
N Z Med J. 1998 May 22;111(1066):186-8.
To review paediatric exploratory ingestions of paracetamol presenting to Christchurch Hospital Emergency Department.
A retrospective review of all paediatric patients presenting with paracetamol ingestion over a 12 month period.
During the study period there were 88 paediatric presentations for possible toxic ingestions involving paracetamol and 85 of these were exploratory self-ingestion. The male to female ratio was 43:42 and the mean age was 35 months. Paracetamol suspension was ingested in 79/85 cases and tablets in 6/85. The mean four hour plasma level was 162 mumol/L and all levels were well below the possible toxic level (1300 mumol/L). There was very poor correlation between estimated dose ingested and plasma level.
Toxicity from paediatric exploratory ingestion of paracetamol is extremely rare. To reduce the potential for poisoning, bottles and prescriptions of paracetamol should have less than a total dose of 4 g. The authors recommend that unwitnessed exploratory ingestions of paracetamol in children require no treatment if the estimated maximum ingested dose is below 140 mg/kg. Above this dose, treatment is based on the result of a plasma paracetamol level drawn four hours after ingestion. Gastrointestinal decontamination should be reserved for the rare occasions of a definite witnessed ingestion of a dose exceeding 140 mg/kg.
回顾基督城医院急诊科收治的儿童误服对乙酰氨基酚情况。
对12个月期间所有因误服对乙酰氨基酚前来就诊的儿科患者进行回顾性研究。
在研究期间，有88例儿科患者因可能误服对乙酰氨基酚前来就诊，其中85例为误服探索性自服。男女比例为43:42，平均年龄为35个月。85例中有79例误服了对乙酰氨基酚混悬液，6例误服了片剂。4小时时血浆平均水平为162微摩尔/升，所有水平均远低于可能的中毒水平（1300微摩尔/升）。摄入剂量估计值与血浆水平之间的相关性很差。
儿童误服对乙酰氨基酚导致中毒极为罕见。为降低中毒可能性，对乙酰氨基酚的瓶装量和处方总量应低于4克。作者建议，如果估计最大误服剂量低于140毫克/千克，儿童无目击的误服对乙酰氨基酚情况无需治疗。超过此剂量，治疗应基于摄入后4小时测得的血浆对乙酰氨基酚水平结果。胃肠道去污仅适用于明确目击误服剂量超过140毫克/千克的罕见情况。
