Question

A 35-year-old woman presents to the emergency department 4 hours after taking 20 g of immediate-release paracetamol in a suicide attempt. She weighs 60 kg. She is currently asymptomatic. According to Australian paracetamol poisoning guidelines, how should the ingested dose be classified and what is the appropriate next step?

Accepted Answer

She has ingested a clearly toxic dose (>10 g and >200 mg/kg); obtain a paracetamol level at 4 hours post-ingestion and commence acetylcysteine if above the nomogram line

Answer

The dose is below the toxic threshold so no blood tests or treatment are required

Answer

The dose is only toxic if she develops symptoms, so observe without blood tests

Answer

Because she presented within 8 hours, acetylcysteine is not indicated

Answer

Treat with activated charcoal alone and discharge without levels

Practice question