A 22-year-old woman arrives as triage level 2 four hours after ingesting an unknown amount of acetaminophen. She is asymptomatic, AST is normal, and

Question

A 22-year-old woman arrives as triage level 2 four hours after ingesting an unknown amount of acetaminophen. She is asymptomatic, AST is normal, and the acetaminophen level plotted on the Rumack-Matthew nomogram is above the treatment line. Which of the following is the most appropriate next step in management?

Accepted Answer

Start N-acetylcysteine

Answer

Administer flumazenil

Answer

Give activated charcoal at 24 hours as single therapy

Answer

Wait for transaminases to rise before treatment

Answer

Discharge because she is asymptomatic

Acetaminophen overdose — ABEM Board MCQ