A patient with one or more risk factors for increased toxicity following paracetamol (acetaminophen) poisoning requires more aggressive management. These patients have a treatment curve with a cut-off lower than that used for normal individuals.
Patient selection:
(1) presentation within 24 hours after ingestion of paracetamol (acetaminophen)
(2) one or more risk factors for enhanced toxicity
Parameters:
(1) hours since ingestion that plasma sample collected
(2) plasma paracetamol concentration in mg/L
LOG10(cutoff value for paracetamol in mg/L) =
= 2.292 - (0.07514 * (hours since ingestion))
cutoff value in mg/L =
= 10 ^ (2.292 - (0.07514 * (hours since ingestion)))
Interpretation:
• A patient with a plasma paracetamol (acetaminophen) concentration >= (cutoff) should receive therapy.
• A patient with a plasma paracetamol (acetaminophen) concentration < (cutoff) can be observed.
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