A 17-year-old girl presents to a Newcastle ED, triage category 2, after taking repeated supratherapeutic paracetamol doses over 36 hours. She has

Question

A 17-year-old girl presents to a Newcastle ED, triage category 2, after taking repeated supratherapeutic paracetamol doses over 36 hours. She has nausea, ALT 92 U/L and a paracetamol concentration of 28 mg/L. INR is 1.3. What is the most appropriate management?

Accepted Answer

Start IV acetylcysteine and discuss with poisons service

Answer

Discharge because ingestion is staggered

Answer

Give activated charcoal at 36 hours

Answer

Start oral methionine and no monitoring

Answer

Delay treatment until ALT exceeds 1000 U/L

Paracetamol poisoning — ACEM Fellowship MCQ

A 17-year-old girl presents to a Newcastle ED, triage category 2, after taking repeated supratherapeutic paracetamol doses over 36 hours. She has nausea, ALT 92 U/L and a paracetamol concentration of 28 mg/L. INR is 1.3. What is the most appropriate management?