Management of acute paracetamol poisoning

Since 2010, paracetamol has been the most common agent used in Hong Kong for deliberate self-harm by overdose and poisoning.1 It is readily available over-the-counter and is commonly prescribed by doctors. Over the years, cases of liver failure accumulated when patients were treated according to the 200-treatment line. [...]in 2012 the health department in the UK decided to abandon the two-level approach and apply one treatment line of 100 mg/L for all patients.3 In the article written by Chan et al,4 the 150-treatment line has been evaluated and identified a failure rate of 0.45%. According to the author's own experience in managing such patients, history taking must be done tactfully and sometimes repeatedly from different sources of information.