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HardEmergencyParacetamol overdose - delayed presentationau-amcau-acem

A 17-year-old boy is brought to the emergency department after collapsing at a party. Friends report he ingested an unknown quantity of paracetamol tablets about 16 hours ago in an attempt to self-harm. He is nauseated but haemodynamically stable. Serum paracetamol level is detectable but falls below the nomogram treatment line at 16 hours. What is the most appropriate management?

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