A woman presents after taking paracetamol tablets in a staggered overdose over 12 hours. What is the correct approach?

Answer and explanation

Correct answer: B. Start acetylcysteine without waiting for a paracetamol level

  1. Step 1: The treatment line applies to a single ingestion timed to 4 hours or later.
  2. Step 2: In staggered overdose, acetylcysteine is given regardless of the level, as timing cannot be interpreted.
Answer
Start acetylcysteine without waiting for a paracetamol level.
Why not the others: Wait four hours after the last tablet, then use the treatment line to decide: The nomogram cannot be used when ingestion is spread out. Give oral N-acetylcysteine at home with a telephone review the next morning: Home treatment is not appropriate for a significant overdose. Give activated charcoal alone and discharge her once she is asymptomatic: Charcoal alone does not prevent liver injury after 12 hours.

Practise more Cardiovascular, neurological and metabolic emergencies.

Free questions with an explanation for every one, and full timed PLAB 1 (GMC, international medical graduates) mock tests.

All Cardiovascular, neurological and metabolic emergencies questionsTake a mock test

More Cardiovascular, neurological and metabolic emergencies questions