{
  "abstract": "Background Treatment with the 12-hour Scottish and Newcastle Antiemetic Protocol (SNAP) acetylcysteine regimen is associated with decreased length of stay and fewer anaphylactoid reactions in adult patients, and the protocol is now recommended by several UK organisations and used widely. One potential barrier to adoption is concern regarding the potential for variation in protocol performance with patient age. Anecdotally, this has led to slower adoption in paediatric settings.Methods Secondary analysis of data from 2212 patients at the Royal Infirmary of Edinburgh, UK, treated with acetylcysteine for paracetamol overdose between 28 September 2013 and 27 September 2017. Patients were grouped into 10-year age ranges to allow comparison of treatment regimen performance across ages. Groups were compared for their rates of anaphylactoid reactions, duration of admission attributable to acetylcysteine infusion and severity of liver injury assessed by biochemical markers.Results Patients in all age groups treated with SNAP experienced statistically significant reductions in anaphylactoid reactions. There were no significant differences in the severity of acute liver injury as assessed by biochemical results.Conclusion This secondary analysis provides data to support the use of SNAP regardless of patient age and reassure clinicians that there is no evidence of previously unrecognised variation in protocol performance.",
  "authors": [
    {
      "affiliations": [
        "The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, UK",
        "The University of Edinburgh Centre for Precision Cell Therapy for the Liver, Edinburgh, UK"
      ],
      "name": "Christopher Humphries"
    },
    {
      "affiliations": [
        "National Poisons Information Service, Edinburgh, UK"
      ],
      "name": "Janice Pettie"
    },
    {
      "affiliations": [
        "Bolton NHS Foundation Trust, Bolton, UK",
        "Edge Hill University, Ormskirk, UK"
      ],
      "name": "Bridget Agboola"
    },
    {
      "affiliations": [
        "The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, UK"
      ],
      "name": "Thomas M Caparrotta"
    },
    {
      "affiliations": [
        "The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, UK"
      ],
      "name": "Robert W Hunter"
    },
    {
      "affiliations": [
        "National Poisons Information Service, Edinburgh, UK"
      ],
      "name": "Emma Morrison"
    },
    {
      "affiliations": [
        "National Poisons Information Service, Edinburgh, UK"
      ],
      "name": "Euan A Sandilands"
    },
    {
      "affiliations": [
        "The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, UK"
      ],
      "name": "David J Webb"
    },
    {
      "affiliations": [
        "The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, UK"
      ],
      "name": "Michael Eddleston"
    },
    {
      "affiliations": [
        "The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, UK",
        "The University of Edinburgh Centre for Precision Cell Therapy for the Liver, Edinburgh, UK"
      ],
      "name": "James Dear"
    }
  ],
  "title": "Scottish and Newcastle Antiemetic Protocol (SNAP) 12-hour acetylcysteine regimen for paracetamol overdose reduces anaphylactoid reactions without compromising hepatic protection in all age groups: a secondary analysis",
  "uid": "1460d50f-c3c1-5e00-9842-bf64544e44bb"
}