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Examination 17744 Paracetamol (Acetaminophen, N-Acetyl para-amino phenol) Purpose of test Investigation of suspected overdose Sample Blood Sample Tube/Container Adult- Yellow top or Green top Lithium Heparin Gel Sample should be taken >4 hours after overdose. An accurate sample time from ingestion is critical for interpretation Sample Volume 4ml Minimum (see calculation of minimum volume) Special Precautions No specific requirements Request Form: Clinical Chemistry & Haematology Requests Laboratory Biochemistry Biological reference range Therapeutic level at 4 hours: 5 - 12 mg/L Clinical decision values See paracetamol poisoning guidelines in the medical section of Trust clinical guidelines web page Factors affecting performance In sample where icterus (bilirubin), haemolysis or lipemia is indicated by the manufacturer to cause inaccuracy of >10%, the result will be dashed out or reported with a disclaimer Plasma concentrations taken within 4 hours of ingestion cannot be reliably interpreted because of the possibility of continued drug absorption and distribution Prone to interference from haemolysis Amitriptyline and imipramine showed a significant negative interference. Inaccurate time from ingestion will adversely impact on result interpretation Turnaround times: The Laboratory aims to report 90% of requests within the stated time from receipt Urgent - 1 hour Ward - 4 hours GP and OPD – 1 working day Patient preparation No specific requirements Instructions for patient collected sample Not applicable Note: Printed documents are not controlled Page 1 of 2 Sample transportation No specific requirements Special handling needs No specific requirements Patient consent required Implied consent Specific rejection criteria Generic rejection applies Additional information Part of overdose screen Minimum Retest Intervals- not available References - Lab Tests Online - Roche insert 2011-03, V 1 English - WHO use of anticoagulants in diagnostic laboratory investigations - Trust guidance on management of paracetamol poisoning - Commission human medicine Paracetamol overdose guidance September 2012 - BNF 65 page 3 Note: Printed documents are not controlled Page 2 of 2