THE CLINICAL-VALUE OF SCREENING FOR PARACETAMOL IN PATIENTS WITH ACUTE-POISONING

In this retrospective study, we determined the clinical value of scree ning for paracetamol in 294 Chinese patients with acute poisoning pres enting to the general medical wards at the Prince of Wales Hospital be tween January 1992 and Tune 1993. Of the 86 patients suspected of havi ng ingested paracetamol, eight had levels above the recommended 'treat ment line'. Of the 208 patients with no suspected paracetamol ingestio n, four were found to have elevated but non-toxic plasma levels. The i ncidence of missed, potentially serious paracetamol poisoning in our p atients with no suspected paracetamol ingestion is extremely uncommon. Routine screening of all patients with acute poisoning for toxic plas ma paracetamol concentrations is therefore not indicated and should ne ver be a substitute for thorough history taking and physical examinati on.