Overdose Management

New Clinical Decision Framework on the Management of Acetaminophen Poisoning in the US and Canada

A panel of 21 experts from 4 clinical toxicology societies (America’s Poison Centers, American Academy of Clinical Toxicology, American College of Medical Toxicology, and Canadian Association of Poison Control Centers) was convened to develop a consensus statement for the assessment, management,  and treatment of acetaminophen poisoning, based on the collection of 84 guidelines and 278 medical publications.1

The development of this framework is critically important because prior to this qualitative study, there were no formal nationwide guidelines for specialists in poison information or emergency department management of acetaminophen poisoning. Unlike other countries, the US and Canada have not  developed authoritative clinical practice guidelines for acetaminophen poisoning.1 

The panel created a decision framework and determined the appropriate management of patients with acetaminophen poisoning, including1:

  • Developing guidelines for emergency department management of single or repeated ingestion of acetaminophen 
  • Addressing extended-release formulation, high-risk ingestion, coingestion of anticholinergics or opioids, and intravenous acetaminophen use 
  • Revised Rumack-Matthew nomogram only including lines that guide clinical action
  • Management of patients younger than 6 years of age, women who are pregnant, and those who weigh more than 220 lbs (100 kg) 

Having consistent evidence-based recommendations for medical, pharmacy, nursing education and practice can help to optimize patient care when acetaminophen poisoning occurs.1

Kenvue is committed to supporting frontline clinicians with the latest evidence on managing acetaminophen overdose and potential misuse.

These new guidelines are a testament to our commitment to put people first, advance the science, and improve patient outcomes, while ensuring both doctors and patients have the information they need to use our products safely and appropriately.

Overdose management figure 1
Figure 1. Management of Acetaminophen Poisoning in a Medical Facility
Overdose management figure 2
Figure 2. Revised Rumack-MatthewNomogram for the Acute Ingestion of Acetaminophen

REFERENCES: 1. Dart RC, Mullins ME, Matoushek T, et al. Management of Acetaminophen Poisoning in the US and Canada: A Consensus Statement. JAMA Netw Open. 2023;6(8):1-11.