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Emerg Med J 20:366-367 doi:10.1136/emj.20.4.366
  • Best evidence topic reports

Oral methionine compared with intravenous n-acetyl cysteine for paracetamol overdose

  1. Walid Alsalim, Specialist Registrar,
  2. Mohamed Fadel, Specialist Registrar
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK; kevin.mackway-jones:man.ac.uk

      Abstract

      A short cut review was carried out to establish whether methionine was better than n-acetyl cysteine at reducing the severity of liver damage after paracetamol overdose. Thirty nine papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.


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      Poll

      Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?

      Results

      0.5% - 43% response rate
      3% - 41% response rate
      10% - 16% response rate

      Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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