Guidelines will standardize treatment across U.S. and Canada and improve patient outcomes

New consensus guidelines for the management of acetaminophen poisoning published in JAMA Network Open  are now available to be used by Poison Centers and hospitals in the U.S. and Canada. Acetaminophen overdose continues to be a leading cause of accidental and intentional poisoning, with more than 80,000 cases reported in 2021 to U.S. Poison Centers. When not treated properly, acetaminophen poisoning causes liver failure and death.

For the first time-ever a panel of more than twenty experts were convened from America’s Poison Centers, American Academy of Clinical Toxicology (AACT), American College of Medical Toxicology (ACMT), and the Canadian Association of Poison Centres & Clinical Toxicologists (CAPCCT) to develop consensus guidelines for the treatment of acetaminophen poisoning. The guidelines were developed through a systematic review of the medical literature, including existing guidelines and 278 publications.

“These guidelines address a critical gap in the care and treatment of patients with acetaminophen poisoning, and are a significant achievement for the medical and public health community,” said Richard Dart, MD, PhD, Director of the Rocky Mountain Poison Center and chairperson of the acetaminophen panel. “Standardized guidelines will ensure that patients receive life-saving treatment sooner, resulting in better patient care and outcomes, and has the potential to save costs by reducing the length of hospital stays.”

The guidelines addressed the following topics:  

•  Assessing risk of liver injury
•   Recommended dosage and administration of activated charcoal and N-Acetylcysteine (NAC), which are used to treat acetaminophen overdose
•  Special populations (i.e. pregnant persons, children)
•   Assessing and treating high-risk ingestions (formerly called "massive overdose”)

“I want to extend a huge congratulations to all the members of the panel who participated in the development of these guidelines,” said Carol DesLauriers, PharmD, Board President, America’s Poison Centers and Assistant Vice President of the Illinois Poison Center and Illinois Health and Hospital Association. “This milestone is a testament to the hard work and collaboration among the different organizations. More importantly, it will help us drive our collective public health mission forward, and reduce the number of poison-related health emergencies.”

To read a full copy of the new guidelines, visit JAMA Network Open.

For questions related to acetaminophen or emergency assistance, contact:

•  Poison Help at 1-800-222-1222 to speak with a poison expert, or
• Visit PoisonHelp.org (the official website for America’s Poison Centers) for resources and support.