History A 19-year-old student has been admitted to hospital after being found unconscious in her room in university halls of residence. Her room-mate told the paramedics that she had recently failed her end-of-year exams and had ended a long-term relationship earlier that week. She is not known to have any medical history and took occasional painkillers for a knee injury. She was found with several empty packets of paracetamol around her. A suicide note was discovered next to her.
Examination The student is drowsy but responsive. She admits to taking thirty 500 mg paracetamol tablets and eight 30 mg codeine phosphate tablets with a bottle of wine approximately 4 hours earlier. Observations: temperature 36.4°C, heart rate 80/min, blood pressure 110/70 mmHg, respiratory rate 12/min, SaO2 96 per cent on room air. What are the consequences of a paracetamol overdose? *This case is from…
