Paracetamol Overdose/Poisoning Patient Treatment & Management in Emergency, Toxicology Lecture USMLE

[@MedNerdDrWaqasFazal]

IMPORTANT CLINICAL POINTS: If patient has ingested >150mg/kg of Paracetamol, then treatment depends on timing of presentation 1. if patients presents within < 1 Hour of ingestion : Give Activated Charcoal(1g/kg max upto 50g). then wait for 4 hours post ingestion and send paracetamol levels, if still elevated (100mg/L at 4 hours) give NAC. 2. if patients presents within 1-3 Hours of ingestion : Activated charcoal has no role. Wait for 4 hours post ingestions and send paracetamol levels (It means that if patient took paracetamol at 12pm, presented to hospital at 2pm, then doctor should wait for 2 hours and send paracetamol levels at 4pm), if still elevated (100mg/L at 4 hours) give NAC. 3. if patients presents within 4-8 Hours of ingestion : Don't Wait, take blood immediatly and check Paracetamol levels, if elevated Start NAC 4. if patients presents after 8 Hours of ingestion: Give NAC straightaway, after giving NAC send blood sample for paracetamol levels. 5. If time of ingestion unknown: Give NAC DON'T FORGET TO CLICK ON SUBSCRIBE BUTTON 😊 FOLLOW ME ON Instagram: instagram.com/docwaqasfazal/ Facebook: facebook.com/Drwaqasfazal

[@bahiachibi895]

Thank u for the video it is awesome

[@rahika2004]

hey I take 6 paracetamol at one time . Now I am suffering from vomit so what I have to do

[@Medicos-knowlageble]

You are such a quintessential teacher your way of teaching is pulchritudinous.

[@swathipandla8615]

Really u are explaining clearly

[@aishah2097]

Thnku so much sir, no one explained me like this... Amazing sir. It's very helpful for us at phc level for Medical officers

[@nisekkhatiwada1303]

A very informative lecture sir ❤️ We subscribers are very grateful getting teacher/enabler like you sir ❤️🇳🇵 Much love from Nepal sir 🇳🇵

[@alfiyafiya6757]

Excellent presentation ,helps so much

[@draishwaryarobbin2049]

Your videos are really helpful boss… hope to get time to upload a video daily as i wait for whats coming next.. :)

[@MedNerdDrWaqasFazal]

So Nice of you Dr. Aishwarya Robbin 😊

[@avgjoedoc9629]

This is such a useful lecture, Sir.

[@shashankmishra5254]

Again Superb Sir.,🙏🙏

[@salmanjavid295]

respected sir

[@Leoadiil]

You are the first Indian man 😍🫡 I have ever listened to with great pleasure and happiness and your explanation is very beautiful may god bless you😍❤

[@blessedslave]

Bio says he's from Pakistan

[@cavidmammadov2987]

Thanks for video. I have a question in term of treatment. If the patient has diabetes can we use saline infusion instead of glucose at the same dose like glucose

[@MedNerdDrWaqasFazal]

Yes you can give it in half saline. 0.45 saline

[@junaidnazir2618]

I hope u will help me and give me right direction

[@junaidnazir2618]

Hi sir.I have question how can we different post hepatic jaundice ,pre ,post haptic jaundice symptoms rather then paracetamol poisoning bcz the syomtams almost some seen daily practice

[@ZahidHussain-ht4tw]

Thanks sir.. very nice video..

[@jaushwanthD-pu1dh]

Paracetamol poisoning is slow way to so iam trying it with alcohol. Hope my journey will be fast

[@Rick_Cleland]

It's not, and I'm speaking for first-hand experience.

[@lakshmanayb5009]

Tqsm sir

[@radhwanabdulla6806]

Thanks

[@lianbeletty7977]

Nice

[@rajeshroy306]

Crystal clear explanation sir

[@idkwhattonameit8359]

Thx doc ! Can someone explain what it meant by over 1 hr then over 4 and 16 hrs ?

[@Ajsavage.]

Have u took premium subscription for living ?

[@evolvingdaily7762]

Sir pl need little help, you said in symptoms that metabolic acidosis develop due to hyperventilation, I don't get it!

[@MedNerdDrWaqasFazal]

I am very sorry. It was by mistake. Metabolic acidosis develops due to lactic acid buildup not by hyperventilation. Thank you for your response.

[@evolvingdaily7762]

@@MedNerdDrWaqasFazal thanku sir, I'm preparing for part 2 exam fcps, your videos are v helpful!

[@MedNerdDrWaqasFazal]

Wish you all the best. May God ease everything for you. I am very glad to hear that. 😊

[@ExtensiveMedicine]

Nice video!

[@jennelynjoymacugay1913]

Gastric lavage 1st or the antidote? What is priority

[@Mkhan-tl3yx]

Sir cotraindication of nacetylcystin plus when to strt methionin please

[@aadrshclinic9062]

Upload videos on intra mascular injection with complication

[@MedNerdDrWaqasFazal]

Sure Chetan I will. 😊

[@jennelynjoymacugay1913]

If 45 mins passed and patient ingested 15 maximum strenght of acetaminophen whatbis the PRIORITY antidote or gastric lavage ? I saw questions that have diferebt answers 15 yrs old and a Child ?

[@shivamsharma-mm2mc]

You are amazing ✨

[@MedNerdDrWaqasFazal]

Thank you Shivam 😊

[@ramjibanyadav28]

great ❤

[@misbahumar4577]

👍👍👍

[@dumb2pro]

Sir yesterday i have mistakenly taken calpol 600 and algina 500 both 3 times a day sir what should i do would it affect me plzz reply sir i am too much scared about it

[@nourwaleed6780]

I need a source about the paracetamol towards children

[@chotiooo9151]

What is the difference between N acetyle cystien and Acetyle cystein please explain doctor

[@junaidnazir2618]

Good question

[@syedahsan538]

Sir i have a question when do we start treatment with NAC ... do we wait for paracetamol levels.. or just start the treatment..???

[@MedNerdDrWaqasFazal]

Syed Ahsan If patient has ingested >150mg/kg of Paracetamol, then treatment depends on timing of presentation 1. if patients presents within < 1 Hour of ingestion : Give Activated Charcoal. then wait for 4 hours post ingestion and send paracetamol levels, if still elevated give NAC. 2. if patients presents within 1-3 Hours of ingestion : Activated charcoal has no role. Wait for 4 hours post ingestions and send paracetamol levels, if still elevated give NAC. 3. if patients presents within 4-8 Hours of ingestion : Don't Wait, take blood immediatly and check Paracetamol levels, if elevated Start NAC 4. if patients presents after 8 Hours of ingestion: Give NAC straightaway, after giving NAC send blood sample for paracetamol levels.

[@Kichu8032]

Please help. Accidentally I gave 2ml paracetamol to my 10 months baby by mistake. Doctor prescribed 1.2 ml. Do I have to worry? Now its 2 and half hours and he looks normal and very active

[@souravmajumder5807]

Don’t worry….bt next time u should be more conscious….pcm is hepatotoxic when u consume it for long time with overdose….bt incase of child does is very important….so don’t do that again

[@souravmajumder5807]

Bt yes.if u intake large amount of pcm at a time …it can also damage your liver

[@hamshan97]

How was your baby after taking overdose

[@Kichu8032]

@@hamshan97 It was just once. So no problem

[@williamsagunbiade105]

Thanks for the helpful video, pls what is the place of Measuring serum paracetamol level and the timing before the use of NAC?

[@MedNerdDrWaqasFazal]

If patient has ingested >150mg/kg of Paracetamol, then treatment depends on timing of presentation 1. if patients presents within < 1 Hour of ingestion : Give Activated Charcoal. then wait for 4 hours post ingestion and send paracetamol levels, if still elevated give NAC. 2. if patients presents within 1-3 Hours of ingestion : Activated charcoal has no role. Wait for 4 hours post ingestions and send paracetamol levels, if still elevated give NAC. 3. if patients presents within 4-8 Hours of ingestion : Don't Wait, take blood immediatly and check Paracetamol levels, if elevated Start NAC 4. if patients presents after 8 Hours of ingestion: Give NAC straightaway, after giving NAC send blood sample for paracetamol levels.

[@ygg5476]

You did not discuss the graph

[@raninetawate]

I ate more than 30 tablets but nothing happen

[@Leoadiil]

👏🏻👏🏻👏🏻👏🏻👏🏻👏🏻👏🏻👏🏻

[@TillyHarris]

Hi, my friend took 20 paracetamols and experienced extreme liver pain and vomiting/nausea etc. This was months ago and she has had no treatment. What do I do?

[@Punkinapp]

did she took that in 1 go

[@aimanmalik4411]

@animeraven976😂

[@mokshithhanshith7893]

I suffering with skin rash an swelling after using paracetamol. please suggest solution

[@sujeetshah4129]

NAPQI sir its not NAPQ1.

[@Tulipstoo]

لا خطأ الباراستمول مضر وفيه جرعة محددة له و هي اكبر من 150 ملي غرام لكل كيلو غرام للشخص البالغ يعني اضرب الوزن في 150 تطلع الجرعة السامة من الباراسيتامول اللي تأثر على الشخص و تسمم الباراسيتامول يؤدي الى تسمم الكبد وفشله، فمعلومتك خطأ أن الجرعة الزائدة غير مهمة ويا ريت ما تنشر معلومات طبية خطأ لمتابعينك خصوصا اغلبهم يعتمد على كلامك و ممكن يتألم وياخذ باراسيتامول اكثر من المطلوب ويفشل كبده ويموت واصلا الجرعة التي لا يسمح بتجاوزها للبالغين هو اربعة غرام خلال 24 ساعة و البنت اخذت ٦ خلال ساعة يعني تجاوزت الجرعة التي ينصح بها اصلا انا طالبة طب و هذا الكومنت للفائدة، يا ريت تثبته حتى المتابعين يدرون اكيد انت ما كنت تدري بعد 🌱

[@nirobminar606]

I am dying from overdose and nobody cares🙂

[@MedNerdDrWaqasFazal]

nirob minar, I am sorry that you feel this way. You can share it with me.

[@nirobminar606]

@@MedNerdDrWaqasFazal I took 12 paracetamol of 500 mg yesterday and I vomited after one hour and then Somehow I managed to sleep after that waking up in the morning I realized that it will damage my liver and I will be a burden for everyone I told my sister and she told me drink tamarind juice to vomit and I drank that after 12-14 hours later of overdose and I vomited but nothing came out except that tamarind juice now 24 hour’s have passed but I am unable to visit doctor as I am a student of class 10. I am having pain in my lower stomach. If you can tell me any solution please help me I need help.

[@nirobminar606]

@@MedNerdDrWaqasFazal I have sent you a message on your page Sir please help me if you can

[@MedNerdDrWaqasFazal]

You may see your doctor. And tell your guardians about this situation. Your doctor may run a few tests to see if liver is doing fine.

[@nirobminar606]

@@MedNerdDrWaqasFazal Thank you for the suggestion sir. Assalamualaikum.

[@nisekkhatiwada1303]

Sir what is the toxic paracetamol dose? A. >150mg/kg/day B. >200mg/kg/day I'm a little bit confuse about this...

[@armouredspartan8639]

>150mg/kg/day