Ep 180 Acetaminophen Poisoning – Pitfalls in Assessment and Management
Emergency Medicine Cases
Is It Reasonable to Start NAC in a Patient With a Massive Overdose?
The majority of acetaminophen overdoses get treated with an acetylcysteine within eight hours. If your patient presents at the four hour mark and you can get an acetaminophen concentration back in time, you can wait because they may not need it. We want to be starting NAC right away should apply, and that's how you should do it. Would it be reasonable in a patient who you suspect might be a massive overdose? You haven't got any levels back yet to ask the nurse to get some NAC ready so that when you do make that decision to give the NAC, they can give it immediately.
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