Objectives: To determine the type of paracetamol nomograms used in Australasian EDs. To review the literature to determine the evidence base for existing nomograms. Methods: A cross sectional descriptive study via postal survey of all Australasian EDs accredited for specialist emergency medicine training by the Australasian College for Emergency Medicine (ACEM). A literature review using Knowledge Finder search engine was employed. Results: The response rate was 87%. The most commonly used nomogram had a four‐hour treatment level of 1300 µmol/L (69%). A total of 22% of respondents used a four‐hour treatment level of 1000 µmol/L. Two departments (3%) treated all patients above the 660 µmol/L line. Eleven departments (15%) did not have a treatment line below 1300 µmol/L. Conclusion: Practice varies in Australasian EDs. Patients with paracetamol levels below the 1300 µmol/L have been reported in the literature to develop hepatotoxicity, and deaths have been documented. N‐acetylcysteine is extremely safe when used in the recommended dosages.

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