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Paracetamol Poisoning — RACP Paediatrics MCQ

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ModerateEmergency PaediatricsParacetamol PoisoningRACP Paediatrics

An 18-month-old child presents after witnessed ingestion of an unknown quantity of paracetamol tablets approximately 2 hours ago. She weighs 12 kg and appears well. What is the most appropriate management?

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Correct answer: A — Take a serum paracetamol level at 4 hours post-ingestion and plot on the Rumack-Matthew nomogram

For acute single paracetamol ingestion, a serum paracetamol level should be taken at 4 hours post-ingestion (or as soon as possible thereafter) and plotted on the Rumack-Matthew (treatment) nomogram. If the level is above the treatment line, IV NAC is commenced. Activated charcoal may be given within 1–2 hours of ingestion if the ingested dose is >200 mg/kg. Ipecac is no longer recommended.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Paracetamol Poisoning