Which resources or guidelines should I consult for managing specific poisonings, such as paracetamol or opioid overdose?

For the management of specific poisonings such as paracetamol or opioid overdose, you should primarily consult the following UK guidelines:

• CKS - Poisoning or overdose ¹
• CKS - Opioid dependence ²

Key aspects for Paracetamol Poisoning from CKS - Poisoning or overdose:

• It is especially important to establish the exact timing(s) of ingestion in paracetamol poisoning ¹.
• Paracetamol is one of the drugs that requires emergency measurement of its plasma or serum concentration to guide clinical management ¹.
• General management for poisoning involves assessing the person's overall status using the ABCDE approach ¹.
• Emergency transfer to hospital should be arranged if the person is unconscious, has reduced consciousness, reduced respiratory rate, reduced oxygen saturation, hypotension, tachycardia, bradycardia, irregular pulse, hypothermia, hyperthermia, or has had a seizure ¹.
• Activated charcoal can be used to prevent absorption of the poison, being most effective if given within 1 hour of ingestion ¹.

Key aspects for Opioid Overdose from CKS - Opioid dependence:

• Signs of opioid overdose include central nervous system depression, constricted pupils, and respiratory depression or apnoea ².
• If the person is unconscious and not breathing, or if there are no signs of life, commence cardiopulmonary resuscitation (CPR) ².
• In the presence of reduced consciousness but continued breathing, place the person on their side in the recovery position and clear the airway of any vomit if necessary ².
• Administer naloxone (an opioid antagonist) through intravenous, intranasal, or intramuscular injection ².
• Naloxone is short-acting, so repeated injections or intravenous infusion may be needed if longer-acting opioids have been taken ².
• Higher doses of naloxone are required when reversing the effects of buprenorphine due to its higher receptor affinity ².
• The primary aim of treatment is to reverse the toxic effects of opioids to prevent respiratory arrest, airway loss, or other opioid-related complications, not necessarily to restore a normal level of consciousness ².