EMCrit Podcast
EMCrit 351 - Severe Acetaminophen (Tylenol) Toxicity
Jun 15, 2023
Exploring the management of severe acetaminophen toxicity, including challenges in diagnosis, lab tests, and NAC dosing protocols. Discussion on femepazol as an ancillary therapy, dialysis recommendations, and treatment strategies. Insights on monitoring liver failure patients and potential NAC interactions with coagulation factors.
32:27
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Quick takeaways
- Massive acetaminophen ingestion may not fit traditional toxicity profiles, requiring a high index of suspicion for severe cases.
- Early initiation of acetylcysteine treatment based on clinical suspicion is crucial in managing severe Tylenol poisonings.
Deep dives
Defining Massive Acetaminophen Ingestion
Massive acetaminophen ingestion lacks a unanimous definition in the literature, with some defining it by ingested dose or serum acetaminophen concentration. The focus is on identifying mitochondrial dysfunction as part of the clinical presentation in severely poisoned patients, indicating a different scenario than common ingestions.
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