Question

A 24-year-old man presents to the emergency department 3 hours after ingesting 30 x 500 mg Paracetamol tablets (15 g) in a deliberate self-poisoning. He is 70 kg, alert and haemodynamically stable. What is the most appropriate next step in management?

Accepted Answer

Measure Paracetamol concentration now and plot on the nomogram at 4 hours post-ingestion

Answer

Reassure and discharge because he is asymptomatic at 3 hours post-ingestion

Answer

Commence intravenous N-acetylcysteine immediately without Paracetamol level

Answer

Arrange urgent haemodialysis

Answer

Give activated charcoal only and no further treatment is needed

Practice question

A 24-year-old man presents to the emergency department 3 hours after ingesting 30 x 500 mg Paracetamol tablets (15 g) in a deliberate self-poisoning. He is 70 kg, alert and haemodynamically stable. What is the most appropriate next step in management?