Warning note on a blood gas report leading to diagnosis of acetaminophen overdose.
OBJECTIVE
To report a case of acetaminophen toxicity diagnosed after a warning note of "interfering substances" on the blood gas report, leading to early and successful treatment.


METHODS
Case report.


METHODS
Tertiary-care pediatric intensive care unit.


METHODS
A 14-yr-old boy admitted unconscious with lactic academia and hyperglycemia.


METHODS
Routine investigations.


RESULTS
His initial investigations revealed hyperglycemia and lactic acidosis. An annotation of "interfering substances" on the blood gas report prompted us to investigate for toxic substances, and an acetaminophen overdose was confirmed.


CONCLUSIONS
A persistent warning note on the blood gas report of a sick child with elevated lactate and glucose should alert the clinician to the possibility of an acetaminophen overdose.
Ashtekar
Chetan S
CS
Pediatric Intensive Care Unit, University Hospital, Queens Medical Centre, Nottingham, UK.
Vyas
H
H
D000082:Acetaminophen / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D000111:Acetylcysteine / Q000627:therapeutic use; D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D001786:Blood Glucose / Q000032:analysis; D011431:Dextropropoxyphene / Q000008:administration & dosage / Q000506:poisoning; D004338:Drug Combinations; D062787:Drug Overdose; D015600:Glasgow Coma Scale; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007773:Lactates / Q000097:blood; D008297:Male; D011041:Poisoning / Q000175:diagnosis; D012640:Seizures / Q000139:chemically induced
D018712:Analgesics, Non-Narcotic; D001786:Blood Glucose; D004338:Drug Combinations; D007773:Lactates; D000082:Acetaminophen; D011431:Dextropropoxyphene; D000111:Acetylcysteine