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Warning note on a blood gas report leading to diagnosis of acetaminophen overdose
1Pediatric Intensive Care Unit, University Hospital, Queens Medical Centre, Nottingham, UK.
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.
Design:
Case report.
Setting:
Tertiary-care pediatric intensive care unit.
Patient:
A 14-yr-old boy admitted unconscious with lactic academia and hyperglycemia.
Interventions:
Routine investigations.
Measurements And Main 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.
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