A 22-year-old woman presents 8 hours after a staggered overdose of paracetamol, taking 10g over the last 4 hours. She is vomiting. Her initial blood t...

Question

A 22-year-old woman presents 8 hours after a staggered overdose of paracetamol, taking 10g over the last 4 hours. She is vomiting. Her initial blood tests (LFTs, INR, U&Es) are normal. What is the most appropriate management?

Accepted Answer

Start N-acetylcysteine (NAC) infusion immediately, regardless of the initial level

Answer

Measure paracetamol level and treat with NAC if above the treatment line

Answer

Measure paracetamol level and treat with NAC only if level is >200mg/L

Answer

Administer activated charcoal

Answer

Observe and repeat bloods in 12 hours

mrcp part 1 MCQ (SBA): Paracetamol Overdose (Staggered)

A 22-year-old woman presents 8 hours after a staggered overdose of paracetamol, taking 10g over the last 4 hours. She is vomiting. Her initial blood tests (LFTs, INR, U&Es) are normal. What is the most appropriate management?