Question

A 22-year-old man is brought to the emergency department 2 hours after ingesting 30 tablets of 500 mg acetaminophen in a suicide attempt. He weighs 70 kg. He is alert and asymptomatic. According to toxicology guidelines, what is the most appropriate next step?

Accepted Answer

Send serum acetaminophen level at 4 hours post-ingestion and start N-acetylcysteine if above treatment threshold

Answer

Reassure; toxicity is unlikely if asymptomatic at 2 hours

Answer

Wait until 8 hours post-ingestion to send a serum acetaminophen level

Answer

Start N-acetylcysteine only if liver function tests become abnormal

Answer

Discharge with psychiatric follow-up only

Practice question

A 22-year-old man is brought to the emergency department 2 hours after ingesting 30 tablets of 500 mg acetaminophen in a suicide attempt. He weighs 70 kg. He is alert and asymptomatic. According to toxicology guidelines, what is the most appropriate next step?