Acetaminophen Overdose

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 4 June 2017

⏱️ 10 minutes

🔗️ Recording | iTunes | RSS

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Summary

Acetaminophen is the most important overdose in toxicology Step 1: Check a Serum Acetaminophen Level Common situations where testing is ordered Suicidal ideation Severe depression Overdose Step 2: Consult the Rumack-Matthew nomogram Only works for acute/single ingestions of acetaminophen Loses reliability if patient is on drugs that affect bowel motility If the time of ingestion […]

Transcript

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0:00.0	Hello, med students. My name is Zach Olson and thank you for downloading this week's episode of the EM Clerkship Podcast.
0:11.3	Over the next two weeks, we are going to cover the king and the queen of all toxicology.
0:19.6	This is what will be on your test. This is what you will be pimped on.
0:23.4	If you want to impress your attending, listen up.
0:33.5	Okay, Doctor, this is Rebecca. It's a 17-year-old female. She took a whole small bottle of Tylenol.
0:38.3	We did bring it with us because her and her boyfriend broke up and she wanted to hurt herself.
0:43.3	She did state that.
0:45.3	The parents are the ones who called us.
0:46.3	She's complaining of nausea and vomiting times two.
0:49.3	Currently BP 110 over 80, Pulse of 100.
0:51.3	Respirations 18.
0:52.3	Kutko's stick of, and no other medial
0:55.2	allergies, and mom and dad are right out here if you have any questions for them.
1:00.6	Okay, good luck, we're back.
1:05.3	This week, we are going to cover the king of tox, the acetaminophen overdose, a Tylenol overdose.
1:15.7	Acetaminopin overdose is a bad deal. In my medicine cabinet right now, literally, I just checked,
1:20.8	I have this big bottle of extra strength Tylenol, 500, 500 milligram tablets, and it was cheap cheap and it just sits there. And if I were to
1:30.3	just start taking a bunch of those, let's say I had a bad shift, whatever, I would die. My liver would
1:36.2	fail. My other organs would shut down and I would die, slowly asymptomatic until it was too late.
1:42.8	And so in my department, every single serious mental health
1:46.1	case is getting a cheap, quick test, a serum acetaminophen level drawn. But more than just that,
1:55.7	what I really want you to remember today is the antidote for acetaminophen overdose. This is what you absolutely have to know
	...

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