Multi-centre Implementation of the SNAP Protocol for Paracetamol Overdose - reducing the length of stay

Aim/Objective/Background: Paracetamol stands as one of the most prevalent drugs of overdose in the UK. The conventional treatment for Paracetamol toxicity involves intravenous administration of N-acetylcysteine (NAC), typically administered over 21 hours in UK hospitals. However, an alternative 12-...

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Main Authors: Roshan Joseph, William Manning, Muniswamy Hemavathi, Richard Austin
Format: Article
Language:English
Published: Discover STM Publishing Ltd 2024-03-01
Series:Saudi Journal of Emergency Medicine
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Online Access:https://sjemed.com/?mno=195539
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author Roshan Joseph
William Manning
Muniswamy Hemavathi
Richard Austin
author_facet Roshan Joseph
William Manning
Muniswamy Hemavathi
Richard Austin
author_sort Roshan Joseph
collection DOAJ
description Aim/Objective/Background: Paracetamol stands as one of the most prevalent drugs of overdose in the UK. The conventional treatment for Paracetamol toxicity involves intravenous administration of N-acetylcysteine (NAC), typically administered over 21 hours in UK hospitals. However, an alternative 12-hour infusion, known as the 'SNAP' regimen, has shown promise in reducing anaphylactoid reactions compared to the standard treatment. This study implemented the SNAP regimen in two District General Hospital Emergency Departments within the same NHS Trust as part of a quality improvement project (QIP), aiming to assess its impact on reducing adverse reactions and inpatient length of stay. Methods/Design: Trust guidelines were revised to recommend the 12-hour SNAP regimen for adult Paracetamol overdose cases, accompanied by a pre-filled prescription chart. A retrospective analysis of patient records and electronic discharge letters was conducted before and after the guideline change to identify NAC recipients and document any adverse reactions. Length of inpatient stay was also documented. Results/Conclusions: Over a three-month period from August to November 2020 across both sites, 60 adult patients received NAC for Paracetamol overdose, with four experiencing anaphylactoid reactions. Following the introduction of the SNAP regimen, spanning from April to June 2021, 36 adult patients received NAC, none of whom experienced adverse drug reactions. Before the guideline change, adult patients admitted for Paracetamol overdose had an average inpatient stay of 48.3 hours, which decreased to an average of 44.5 hours following the adoption of the SNAP regimen. The SNAP NAC regimen demonstrated comparable safety regarding adverse drug reactions while effectively reducing the length of inpatient stay for adults with Paracetamol overdose. [SJEMed 2024; 5(1.100): S15-S15]
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institution Kabale University
issn 1658-8487
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spelling doaj-art-571f0154e18d458a8a2bcf24f04d1e872025-08-20T03:40:33ZengDiscover STM Publishing LtdSaudi Journal of Emergency Medicine1658-84872024-03-015Emirates Society of Emergency Medicine 2023 (ESEM23) Conference AbstractsS15S1510.24911/SJEMed.72-1711529799195539Multi-centre Implementation of the SNAP Protocol for Paracetamol Overdose - reducing the length of stayRoshan Joseph0William Manning1Muniswamy Hemavathi2Richard Austin3Luton and Dunstable Hospital, United Kingdom Luton and Dunstable Hospital, United Kingdom Luton and Dunstable Hospital, United Kingdom Bedford Hospital, United KingdomAim/Objective/Background: Paracetamol stands as one of the most prevalent drugs of overdose in the UK. The conventional treatment for Paracetamol toxicity involves intravenous administration of N-acetylcysteine (NAC), typically administered over 21 hours in UK hospitals. However, an alternative 12-hour infusion, known as the 'SNAP' regimen, has shown promise in reducing anaphylactoid reactions compared to the standard treatment. This study implemented the SNAP regimen in two District General Hospital Emergency Departments within the same NHS Trust as part of a quality improvement project (QIP), aiming to assess its impact on reducing adverse reactions and inpatient length of stay. Methods/Design: Trust guidelines were revised to recommend the 12-hour SNAP regimen for adult Paracetamol overdose cases, accompanied by a pre-filled prescription chart. A retrospective analysis of patient records and electronic discharge letters was conducted before and after the guideline change to identify NAC recipients and document any adverse reactions. Length of inpatient stay was also documented. Results/Conclusions: Over a three-month period from August to November 2020 across both sites, 60 adult patients received NAC for Paracetamol overdose, with four experiencing anaphylactoid reactions. Following the introduction of the SNAP regimen, spanning from April to June 2021, 36 adult patients received NAC, none of whom experienced adverse drug reactions. Before the guideline change, adult patients admitted for Paracetamol overdose had an average inpatient stay of 48.3 hours, which decreased to an average of 44.5 hours following the adoption of the SNAP regimen. The SNAP NAC regimen demonstrated comparable safety regarding adverse drug reactions while effectively reducing the length of inpatient stay for adults with Paracetamol overdose. [SJEMed 2024; 5(1.100): S15-S15]https://sjemed.com/?mno=195539acetaminophenparacetamolpoisoning
spellingShingle Roshan Joseph
William Manning
Muniswamy Hemavathi
Richard Austin
Multi-centre Implementation of the SNAP Protocol for Paracetamol Overdose - reducing the length of stay
Saudi Journal of Emergency Medicine
acetaminophen
paracetamol
poisoning
title Multi-centre Implementation of the SNAP Protocol for Paracetamol Overdose - reducing the length of stay
title_full Multi-centre Implementation of the SNAP Protocol for Paracetamol Overdose - reducing the length of stay
title_fullStr Multi-centre Implementation of the SNAP Protocol for Paracetamol Overdose - reducing the length of stay
title_full_unstemmed Multi-centre Implementation of the SNAP Protocol for Paracetamol Overdose - reducing the length of stay
title_short Multi-centre Implementation of the SNAP Protocol for Paracetamol Overdose - reducing the length of stay
title_sort multi centre implementation of the snap protocol for paracetamol overdose reducing the length of stay
topic acetaminophen
paracetamol
poisoning
url https://sjemed.com/?mno=195539
work_keys_str_mv AT roshanjoseph multicentreimplementationofthesnapprotocolforparacetamoloverdosereducingthelengthofstay
AT williammanning multicentreimplementationofthesnapprotocolforparacetamoloverdosereducingthelengthofstay
AT muniswamyhemavathi multicentreimplementationofthesnapprotocolforparacetamoloverdosereducingthelengthofstay
AT richardaustin multicentreimplementationofthesnapprotocolforparacetamoloverdosereducingthelengthofstay