20th April 2024

A 19-year-old female presents having taken an intentional overdose of 30 x 500mg paracetamol tablets

A 19-year-old female presents having taken an intentional overdose of 30 x 500mg paracetamol tablets. Her plasma paracetamol level is 180 mg at 8 hours post-ingestion, so she is treated with NAC infusions. However, she remains unwell with vomiting and worsening abdominal pain.

Which of the following, if present at 48h post-ingestion, would be an indicator to refer this patient to a specialist unit for consideration of liver transplant?

Select the SINGLE most appropriate option from the list below. Select ONE option only.