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
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Robin Illingworth, Leeds ([log in to unmask])
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