Paracetamol overdose

Question 1

What is the presentation of paracetamol overdose?

Answer 1

Nausea and vomiting

Later - RUQ pain, jaundice, hepatomegaly, altered conscious level

Question 2

What are the investigations for paracetamol overdose?

Answer 2

Serum paracetamol level, LFT (raised ALT), PTT and INR, BM, ABG (lactic acidosis), FBC (leukocytosis, anaemia, thrombocytopenia)

Question 3

What is the management of paracetamol overdose?

Answer 3

If patient presents within 1 hour of ingestion, consider activated charcoal
If not, IV acetylcysteine infusion within 8 hours with close monitoring for anaphylaxis