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Retrieval of Rural and Remote Paracetamol Poisoning in Queensland
Katherine Allen1, Ben Aston1,2, Anja Dehn3
1LifeFlight Retrieval Medicine, Toowoomba, Queensland, Australia.
Emergency Medicine Australasia : EMA
|November 3, 2025
Summary
Many paracetamol overdoses are transferred unnecessarily. Improving rural acetylcysteine availability and guideline adherence could reduce transfers for paracetamol poisoning in Queensland.
Area of Science:
- Emergency Medicine
- Clinical Toxicology
- Public Health
Background:
- Paracetamol overdose is a common clinical presentation.
- Australian and New Zealand guidelines recommend local management of smaller ingestions (<30g) to reduce unnecessary transfers.
- Aeromedical retrieval services play a role in managing these cases, particularly in rural areas.
Purpose of the Study:
- To investigate aeromedical retrievals for paracetamol overdose in Queensland.
- To assess the appropriateness of patient transfers based on existing guidelines.
Main Methods:
- Retrospective observational study of paracetamol overdose retrievals.
- Data collected from January 2017 to December 2023.
- Analysis of ingestion details, investigations, management, and transfer reasons.
Main Results:
- 174 cases were analyzed, with paracetamol isolated in 37%.
- 57% of overdoses were ≤30g.
- Lack of pathology services (50%) and acetylcysteine stock (8%) were primary transfer reasons.
- 35% of transfers were potentially avoidable per guidelines, mainly due to unavailable pathology services.
Conclusions:
- Increased rural acetylcysteine availability is recommended.
- Better adherence to Australian and New Zealand toxicology guidelines could decrease transfer rates for paracetamol overdoses.
- Optimizing local management can improve resource utilization.
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