|
KMID : 1013220170150020094
|
|
Jouranl of the Korean Society of Clinical Toxicology
2017 Volume.15 No. 2 p.94 ~ p.100
|
|
|
Is it Adequate to Determine Acetaminophen Toxicity Solely on Patients’ History? An Analysis on Clinical Manifestation of Intoxication Patients with Positive Serum Acetaminophen Concentrations
|
|
Kim Jee-Hyun
Jeong Won-Joon
Ryu Seung
Cho Yong-Chul
Moon Jang-Hyuck
Choi Hyun-Soo
Yang Song-Hee
Chung Hee-Sun
|
|
|
Abstract
|
|
|
Purpose: Acute acetaminophen intoxication is common but can cause lethal complications. In most domestic emergency departments, clinicians treat acetaminophen intoxication based on patients’ history alone for the lack of a rapid acetaminophen laboratory test. We performed a 20-month study of intoxication patients to determine the agreement between the history of patients and serum laboratory tests for acetaminophen.
Methods: We took blood samples from 280 intoxication patients and sent samples to the laboratory to detect acetaminophen from the sample. Patients were then treated according to their history. Laboratory results came out after patients’ discharge. Agreement between patients’ history and laboratory results were analyzed.
Results: Among the 280 intoxicated patients enrolled, 38 patients had positive serum acetaminophen concentrations; 18 out of 38 patients did not represent a history suggesting acetaminophen intoxication. One patient without the history showed toxic serum acetaminophen concentration. Among the patients with the history, two patients with toxic serum acetaminophen concentration did not receive N-acetylcysteine (NAC) treatment due to their low reported doses, while other 2 patients without significant serum acetaminophen concentration did receive NAC treatment due to their high reported doses.
Conclusion: The study showed good agreement between history and laboratory test results overall. However, some cases showed contrariety between their history and laboratory test results. Therefore, in treating intoxication patients, a laboratory test of acetaminophen with rapid results should be available in most of the domestic emergency departments.
|
|
|
KEYWORD
|
|
|
Acetaminophen, Diagnosis, Intoxication, N-Acetylcysteine, Treatment
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
 
|