Ingested 2

Multisystem Processes & Disorders

{"ops":[{"insert":"Clinical Reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"Decision 1: the probable diagnosis"},{"insert":"\n","attributes":{"header":2}},{"insert":"Jon has ingested 12g of acetaminophen over a 48-hour period. This meets the criteria for repeated supratherapeutic ingestion (RSTI). Acute acetaminophen overdose is defined as ingestion of a toxic amount of acetaminophen within an 8-hour period.\nDecision 2: when to investigate"},{"insert":"\n","attributes":{"header":2}},{"insert":"In patients with RSTI, serum acetaminophen levels should be measured immediately. Estimation at 4-hours post ingestion is done in acute overdose, to allow plotting of levels on the Rumack-Matthew nomogram.\nDecision 3: whether to start NAC pending test results"},{"insert":"\n","attributes":{"header":2}},{"insert":"In patients with RSTI, serum acetaminophen and transaminase levels should be measured immediately\u2014but treatment only started if acetaminophen or transaminase levels are elevated.\nDecision 4: whether to start NAC after seeing test results"}]}

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