What about lab error? If they got it wrong by a factor of two the first
time, was the third level correct? Maybe all their levels that day in the
lab were inaccurate.
----- Original Message -----
From: "Robin Illingworth" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, February 13, 2002 11:33 PM
Subject: Re: Rising paracetamol levels at 12 hours post ingestion?
> In article <[log in to unmask]>,
> <[log in to unmask]> wrote:
> > I have a conundrum...
>
> > A 50-ish year old lady presented 4.5 hours following paracetamol
> > overdose of unknown quantity (taken at 8.30 am). No other
> > significant drugs taken (I can't recall exactly what else she
> > took - but the triage nurse phoned guys and was advised that the
> > most significant problem was with the paracetamol and that the
> > other drugs, whatever they were, wouldn't affect the paracetamol
> > levels).
>
> > Four and a half hour paracetamol level of 127. Lab error
> > discovered at 8.30 pm - they phoned through having re-run the
> > test on the same sample... paracetamol level of 254. At the
> > time that I re-sited the iv to start the NAC I took another
> > specimen - just over twelve hours after the overdose - and sent
> > it to the lab. I figured that with two levels on one specimen
> > that were clinically significantly different it would be wise to
> > check it again. The twelve hour level came back as 270. So,
> > the level went UP from four and half hours to twelve hours post
> > ingestion.
>
> (details snipped)
>
> > Can anyone suggest what might have happened? Has anyone else
> > experienced the same problem?
>
> > Sarah Spencer
> > SpR, Oxford Region
>
>
> I would suggest that she took some more paracetamol while waiting in A&E.
>
> Robin Illingworth
>
> --
> Robin Illingworth, Leeds ([log in to unmask])
> -----------------------------------------------------
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