There is no standard definition of “massive” paracetamol ingestion but those with an initial paracetamol concentration greater than double the 150mg at 4 h nomogram line are at higher risk of acute liver injury and require higher doses of acetylcysteine.So, 10g is the toxic dose for all those heavier than 50kg.
Most patients will present following a single immediate-release paracetamol ingestion of 10g or >200 mg/kg (whichever is less) within 24 hours. The majority of paracetamol overdoses/ poisoning are straight forward, and standard treatment protocols can be applied. Guest Post Dr Angela Chiew – Australian Clinical Toxicologist and Emergency Staff Specialist
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