Acetaminophen intoxication Tylenol overdose

• History / PE:
  Nausea, vomiting , anorexia (early stage)
• Treatment:
  1) Within four hours of ingestion, administer activated charcoal
  
  2) Check serum levels at 4 hour mark (first data/decision point)
  
  3) Refer to Rumack-Matthew normogram (provides likelihood of hepatotoxic effects of acetaminophen OD based on plasma levels and hours after ingestion)
  
  4) Administer N-acteylcysteine / mucomyst as appropriate (can be administered within 8 hrs of ingestion without affecting outcome)