Question

A 45-year-old man presents 6 hours after ingesting 20 tablets of paracetamol 500 mg (total 10 g) in a suicide attempt. He weighs 80 kg. He reports the ingestion occurred 6 hours ago and has had no further doses. According to Australian guidance, which is the most appropriate next step?

Accepted Answer

Take a paracetamol level immediately and decide on N-acetylcysteine based on the nomogram

Answer

Reassure and discharge because the dose is below toxic threshold

Answer

Commence N-acetylcysteine infusion immediately without blood tests

Answer

Observe for 24 hours and repeat LFTs only

Answer

Give activated charcoal and no further treatment

Practice question

A 45-year-old man presents 6 hours after ingesting 20 tablets of paracetamol 500 mg (total 10 g) in a suicide attempt. He weighs 80 kg. He reports the ingestion occurred 6 hours ago and has had no further doses. According to Australian guidance, which is the most appropriate next step?