Monday, April 04, 2016

Are pre-4 hour APAP levels helpful in acute overdose?

They may be of some help, and allow for certain predictions, but do not supplant the need for a 4 hour post-ingestion level and application of the nomogram. This topic is nicely reviewed at Academic Life in Emergency Medicine.

Some cases are not easily applicable to the nomogram (e.g. unknown ingestion time, gradual ingestion over time, transaminases already elevated, etc). Up to Date has a nice section on these situations.

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