Decontamination

Following an acute ingestion of immediate-release paracetamol, offer activated charcoal for gastrointestinal decontamination to alert and cooperative patients within:

• 2 hours of ingesting more than 10 g (or 200 mg/kg in patients under 50 kg) of a solid preparation of immediate-release paracetamol
• 4 hours of ingesting more than 30 g (or 500 mg/kg in patients under 60 kg) of a solid preparation of immediate-release paracetamol.

Activated charcoal is not indicated following ingestion of liquid paracetamol because liquid paracetamol is rapidly absorbed. It is not recommended in drowsy or uncooperative patients.

If the patient is intubated, activated charcoal can be given any time after ingestion via a nasogastric or orogastric tube—confirm correct placement of the nasogastric or orogastric tube beforehand.