The management of paracetamol poisoning in our local health network and consistency with national guidelines is unclear. We conducted a 4-month retrospective study of all paracetamol poisonings identified in two South Australian hospitals. Most presentations were deliberate self-poisoning (90.7%) with immediate-release formulations (88.0%). Although most were managed in accordance with national guidelines, there were deficiencies in documentation of the poisoning details and patient weight as well as cases of underdosing of the antidote. Quality improvement initiatives are needed.

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