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 ta...

Question

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?

Accepted Answer

Start N-acetylcysteine infusion immediately

Answer

No treatment as level is below nomogram line

Answer

Induce vomiting with ipecacuanha

Answer

Observe for 24 hours without treatment

Answer

Charcoal only, as more than 1 hour has passed

au-amc MCQ (SBA): Paracetamol overdose - delayed presentation