Christopher Humphries, Janice Pettie, Bridget Agboola, Thomas M Caparrotta, Robert W Hunter, Emma Morrison, Euan A Sandilands, David J Webb, Michael Eddleston, James Dear
{"title":"苏格兰和纽卡斯尔止吐方案(SNAP):针对扑热息痛过量的12小时乙酰半胱氨酸方案可在不影响所有年龄组肝脏保护的情况下减少类过敏反应:一项次要分析。","authors":"Christopher Humphries, Janice Pettie, Bridget Agboola, Thomas M Caparrotta, Robert W Hunter, Emma Morrison, Euan A Sandilands, David J Webb, Michael Eddleston, James Dear","doi":"10.1136/emermed-2024-214533","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11532,"journal":{"name":"Emergency Medicine Journal","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"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.\",\"authors\":\"Christopher Humphries, Janice Pettie, Bridget Agboola, Thomas M Caparrotta, Robert W Hunter, Emma Morrison, Euan A Sandilands, David J Webb, Michael Eddleston, James Dear\",\"doi\":\"10.1136/emermed-2024-214533\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":11532,\"journal\":{\"name\":\"Emergency Medicine Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-08-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Emergency Medicine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/emermed-2024-214533\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emergency Medicine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/emermed-2024-214533","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
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.
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.
期刊介绍:
The Emergency Medicine Journal is a leading international journal reporting developments and advances in emergency medicine and acute care. It has relevance to all specialties involved in the management of emergencies in the hospital and prehospital environment. Each issue contains editorials, reviews, original research, evidence based reviews, letters and more.