Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Life-threatening poisoning or injury
Airway compromise, shock, reduced consciousness, seizure, arrhythmia, severe bleeding, strangulation, major trauma or a toxic ingestion requires resuscitation and toxicology treatment before a full psychosocial interview.
Action: Use ABCDE, glucose, monitoring, IV access and the substance or injury pathway, contact the National Poisons Information Service through current clinical access when needed and preserve necessary samples. Maintain compassionate observation and gather only essential history while resuscitation proceeds, then complete psychosocial assessment when participation is possible.
Synopsis
Treat poisoning and injury without delay, obtain a needs-led psychosocial assessment at the earliest safe opportunity, understand intent and function without judgement, and coordinate physical, toxicological, safeguarding and mental-health follow-through.
Begin with ABCDE, observations, glucose, consciousness, ECG and focused exposure or injury history; call toxicology, trauma or surgical support according to physiology and substance.
Record substance, preparation, dose, time, pattern, co-ingestants, alcohol, body weight, symptoms, treatment and available packaging without delaying resuscitation.
For a single acute paracetamol ingestion, interpret a timed concentration from at least four hours against the current UK treatment pathway; earlier levels cannot exclude toxicity.
Key red flags
Unknown or staggered paracetamol ingestion, presentation more than eight hours after a potentially toxic dose or unreliable timing requires immediate toxicology-guided action rather than waiting for a routine concentration.
Investigation priorities
01
Immediate physiological assessmentFirst step
Identify airway, respiratory, circulatory, neurological, glucose and temperature threats requiring emergency treatment.
Poisoning responseStabilise and use substance-specific guidance
Recent self-poisoning is known or clinically suspected.
Use ABCDE, glucose, cardiac monitoring and focused substance, formulation, dose, time and co-ingestant history.
Contact toxicology support and obtain timed concentrations, ECG and laboratory tests that change antidote, observation or enhanced-elimination decisions.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.