EM Cases · Paracetamol poisoning
Massive paracetamol overdose — the deteriorating resus station
ACEM Fellowship OSCE clinical-management (resus) station testing 4-hour level rules, two-bag NAC dosing (ANZ current), massive-overdose physiology, and King's College transplant triggers.
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Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A young adult after a massive single acute paracetamol ingestion who develops early lactic acidosis and later evolving hepatic injury.
Stem
All persons, presentations and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
References4ShowHide
- [2]Bateman DN, Dear JW, Thomas SH New regimens for intravenous acetylcysteine, where are we now? Clinical Toxicology (Philadelphia), 2016.PMID 26666290
- [5]Shah AD, Wood DM, Dargan PI. Understanding lactic acidosis in paracetamol (acetaminophen) poisoning. British Journal of Clinical Pharmacology, 2011.PMID 21143497
- [9]O'Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology, 1989.PMID 2490426
- [3]Chiew AL, Reith D, Pomerleau A, Wong A, Isoardi KZ, Soderstrom J, Buckley NA, et al. Updated guidelines for the management of paracetamol poisoning in Australia and New Zealand. Medical Journal of Australia, 2020.PMID 31786822