sandra
Forum Guru
Topics: 180
Posts: 433
|
A.
Administration of dextrose & naloxone
B.
Administration of N-acetylcysteine intravenously
C.
Administration of N-acetylcysteine orally
D.
Immediate measurement of plasma concentration of acetaminophen
E.
Supportive care and measurement of plasma concentration of acetaminophen 3 hours later
Two bewildered parents rush into the emergency department carrying a 3-year-old girl. They
tell the physician at the door that she ingested multiple acetaminophen pills less than an hour
ago. The mother was having a terrible headache in the past 2 days and was taking the
acetaminophen as a pain reliever. She had gotten the medication from the medicine cabinet
and left the open bottle on her desk in the study to go and get a glass of water. When she
returned her daughter was sitting on the desk and putting the tablets in her mouth.
Immediately, the mother removed whatever pills were still in the child's mouth and checked to
insure that all the other medications were safely stored away; when she saw that they were
untouched in the medicine cabinet, the family got in the car to get to the hospital. On the way
to the hospital the girl started vomiting. The mother really does not know how many of the pills
her daughter took because it was not a full bottle to begin with. She removes the half-empty
bottle from her coat pocket and spills the contents on the counter. A total of 36 pills are present
from an original 100 count, 325 mg of acetaminophen each. The child is crying on the
examining table. She appears frightened and diaphoretic, and repeats several times that she
wants to throw up. Her pulse is 120/min and respirations are 24/min. Which of the following is
the most appropriate next step in the management?
___________________
You become what you think you are!
|
| sandra
Forum Guru
Topics: 180
Posts: 433
|
answer given is E. can anyone explain why its not c?
i thought Nacetylcysteine should be given immediatly
___________________
You become what you think you are!
|
| mildus
Forum Guru
Topics: 19
Posts: 614
|
In toxicology there is an order; the most important and the first thing to do is to support vital functions since there is no use to give antidot if the patient dies before that. Thus, the most important is supporting vital functions. Other measures include procedures to inhibit reabsorption and to increase elimination of toxine, and the third measure is antidot. Unfortunately, there is no antidot for every intoxication. In this case, there is an antidot, acetylcystein. I also know that it is very important to give it as soon as possible, thus I don't understand why would we wait for 3 hours to check blood level of acetaminophen.
|
| inkspot
Forum Guru
Topics: 26
Posts: 554
|
the ingestion history is only one hour.
this means that the tablets are still in the stomach. so gastric washing or charchol should be done first. It will be another 3 hrs? when the acet. levels would rise. the primary concern here is the ingested tablets lodged in stomach - stabalize vitals and then go ahead and give n acetyl cystiene.
what do you think about my answer?
___________________
Aagae Aagae Dekho hota hai kiya !!!
|
|
| |
| | | | |
