Following intentional polysubstance ingestion, a 17-year-old girl is admitted to the emergency department in lethargic condition. She took the following unknown number of tablets: Ferrous sulfate OTC products containing 500 mg of Acetaminophen and 25 mg of Diphenhydramine, and another OTC product containing Acetaminophen 250 mg, Aspirin 250 mg, and Caffeine 65 mg.
Vital exams Temperature: 35.4 °C Heart Rate: 153 beats per minute Respiratory rate: 20 breaths per minute BP: 154/103 mmHg Oxygen Saturation: 100% on 1L/min of oxygen (nasal cannula) Neurological exam: alert and oriented without focal deficits Peripheral capillary refill: >3 seconds Unremarkable abdominal exam An episode of hematemesis was observed in initial findings X-ray of abdomen did not show tablets in the GI Laboratory examinations Metabolic acidosis on venous gas with pH- 7.16, pCO 2 – 43 mmHg, lactate- 10.4 mmol/L,…
