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Welcome to golden hour health and safety where we discuss pre-hospital information geared towards emrs emts and paramedics of different levels today we are going to be going over acetaminophen in a very similar style to a typical ems drug card a quick disclaimer before we begin this is for information only and this does not replace your local training protocols
New information or research and is not intended for those not working in towards or involved in healthcare please always follow your local protocol as well as your own scope of practice acetaminophen is also known as tylenol so when you’re talking to your patients and you’re going through your sample history just ensure you sometimes use both those terms with them
As they might only know acetaminophen as tylenol acetaminophen is an antipyretic and a non-opiate analgesic which means that it’s good for reducing pain as well as reducing fevers acetaminophen is also a relatively safe medication to use as it does not cause suppression of platelet aggregation does not cause gastric ulcerations and does not cause renal impairment
So the mechanism of action for acetaminophen is that it inhibits the synthesis of prostaglandins which has the ability to reduce fevers and the pain that we spoke of before now this inhibition is limited to the central nervous system and only has minimal effects at the peripheral sites now acetaminophen is readily absorbed and widely distributed through the oral
Root that’s why in the pre-hospital setting most of this medication is supplied to you in a pill form or in a liquid form most of the acetaminophen is metabolized by the liver and the metabolites are excreted in the urine and the half-life in the plasma is approximately two hours adverse side effects for acetaminophen are actually very rare at the therapeutic
Dose level especially in our use of acetaminophen in the emergent setting even though the adverse side effects are fairly rare as pre-hospital care providers and working in health care we still always need to be looking out for any allergic reaction so always keep it on the table always consider that it’s a possibility and just keep your eye open for any adverse
Side effects as we discussed before acetaminophen does not cause gastric ulcers renal impairment or inhibition of platelet aggregation so that’s not something we’re going to be super concerned about in regards to our pre-hospital treatments however acetaminophen has been associated with stephen johnson syndrome acute generalized exothamidas pustulosis and toxic
Epidermal necrolysis now these conditions can happen in both an acute and a chronic setting so if you start seeing those signs and symptoms this patient does need to be transferred to an emergency department there are a few interactions that we do want to be concerned about the first one being alcohol increased use of alcohol and its consumption can increase
The risk of liver injury especially with a patient with excessive acetaminophen use so just take that into consideration the second is with warfarin it is thought that acetaminophen inhibits warfarin metabolism which can increase the risk of bleeding now our indications for our use of acetaminophen in the pre-hospital setting is typically the use of it as an
Antipyretic we typically don’t use acetaminophen for pain management in that acute emergent setting as it’s just not our first line of medication in regards for pain management as with all medications we need to chat about those contra indications when we speak of these in regards to acetaminophen we’re mostly concerned with allergy and hypersensitivity as well
As those patients with severe active liver disease the following is a common dosing for febrile patients with a temperature of 38 degrees or greater the adult dose that we often see is about 975 milligrams po we typically don’t need to repeat the dose and we want to be cognizant that we don’t exceed that 975 milligrams within that uh four-hour timeline so if our
Patients have already taken acetaminophen at home prior to your arrival we would want to get close to it that number but we wouldn’t want to excessively exceed that number with our pediatric patients we typically see about 50 milligrams per kilogram po again this one is more commonly in a liquid form whereas the adult one is more in a pill form again we don’t repeat
The dose and we try not to exceed that 50 milligrams a kilogram within that four hours so again if that patient did take some tylenol prior to your arrival we want to get as close as we can to that max but we’re definitely not going to go ahead and exceed that dose as with any medical information that you’re learning on the internet in regards to pre-hospital care
If you’re a student or you’re trying to get more familiar with your protocols just understand when it comes to the dosing or what you are not allowed to give or administer to patients is entirely up to your own scope of practice as well as your own protocols so just keep that in mind going forward this is here just for information only so thank you we appreciate
The time that you’ve committed to your education and we firmly believe in continuing education and learning the best that you can if you have any feedback any questions or any comments please let us know
Transcribed from video
Acetaminophen By Golden Hour Health and SafetyliveBroadcastDetails{isLiveNowfalsestartTimestamp2022-01-28T151509+0000endTimestamp2022-01-28T152253+0000}
