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If less than 4 hours then wait for level before starting NAC, if 4-8 hours and rapid turnaround time for getting result back then wait for level, if >8 hours start NAC prior to level. Although NAC is very safe there are some cases of death relating to anaphylaxis so not a risk free treatment. Ed Dr Ed Valentine BM FCEM MRCP MSc (Critical Care) DipIMC RCSEd SpR Emergency Medicine and Critical Care HEMS Doctor Great Western Air Ambulance Immediate Care Doctor - Wiltshire BASICS [log in to unmask] [log in to unmask] Mobile: 07748 303324 www.swiftmedics.net On Wed, 13 Jun 2012 23:21:07 +0100 John Ryan <[log in to unmask]> wrote: > How do list members manage the >'alleged' toxic paracetamol overdose >? > > Start N-acetylcysteine straight up >if less than 4 hours or wait for 4 >hour paracetamol level ? > > Any difference if paracetamol level >available before 8 hours ? > > Any difference if patient in high >risk, (lie eligible for lower level >on graph) > > John Ryan > > > See you at ICEM 2012 in Dublin 27th >-20th June > > (wwww.ICEM2012.org) > > > >