Scenario
A previously well 2 year old boy is brought to your Emergency Department by his mother after he ingested 1.8 g of liquid Paracetamol at 0700 that morning.
He is asymptomatic with normal vital signs.
Serum biochemical investigations were performed four hours after the ingestion; it is now 1200.
Paracetamol Nomogram
Question
a. Discuss the utility of the nomogram shown in this patient (50%) b. Outline your disposition (50%)
Answer
FACEM VAQ Exam 2009.1 – Question 5
- The overall pass rate for this question was 48/81 (59.3%)
- The examiners felt that this was a good question requiring core EM knowledge.
- They were disappointed with the standard of replies.
- Pass criteria were to recognise that the nomogram was reliable in a situation of a known ingestion dose at a specific time and that the ingested dose was sub-toxic.
- Fail criteria were treatment with NAC and admission based on the nomogram results.
See also: Toxicology Conundrum #001.
PDF 
About Mike Cadogan
