SNAP was introduced to CHT in August 2021 it was formally endorsed by RCEM for adults and children in 2023

• SNAP regime is commonly used around the country
• Is a recommended treatment regime on Toxbase.org
• Reduces time our patients require treatment (12 vs 21hr)
• Has a reduced side effect profile for patients
• Decision to treat will remain the same and follow Toxbase.org
• NAC prescription (on EPR):
  • Bag 1 – 100mg/kg over 2hrs (in 200ml 5% glucose or 0.9%NaCl adult or 2ml/kg child)
  • Bag 2 – 200mg/kg over 10hrs (in 1000ml 5% glucose or 0.9%NaCl adult or 20ml/kg child)
• Checking response: Repeat Bloods at 2hrs from end of bag 2 (i.e. 10hrs of treatment)
  • FBC
  • Clotting
  • LFT
  • U+E
  • Paracetamol level 

This should happen on the ward but if there are significant delays it may need doing in ED, and discuss with Med/Paeds regarding further treatment.

The Pier Network in Southampton have produced a SNAP Protocol form which may be helpful for helping less experienced clinicians manage paediatric patients.

Remember all patients who have taken a deliberate overdose require a mental health assessment

In accidental overdoses in children please ensure you are happy there are no ongoing safeguarding concerns.