Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
First minute priorities
Airway risk
GCS decline
Recurrent vomiting
Aspiration risk
Breathing
Hypoventilation from coingestants
Pulse oximetry target normal range
Circulation
Hypotension
Shock state
IV access x2
Rapid bedside threats
Altered mental status with severe metabolic acidosis
Hypoglycemia
Early antidote decision
N-acetylcysteine time to start
Start immediately if time unknown and acetaminophen detectable
Start immediately if delayed presentation and hepatotoxicity suspected
Do not delay for level if ingestion >8 hours possible
Early decontamination decision
Activated charcoal window
Most benefit within 2 hours
Consider up to 4 hours for massive ingestion
Consider up to 4 hours for extended release
Monitoring and escalation
Telemetry
Coingestant concern
Significant electrolyte abnormalities
ICU triggers
Encephalopathy
INR rising with metabolic acidosis
Lactate elevation despite resuscitation
Refractory hypoglycemia
Key concepts
Core framework
Exposure pattern
Acute single ingestion with known time
Acute ingestion with unknown time
Repeated supratherapeutic ingestion
Sustained release ingestion
Two parallel tracks
Serum acetaminophen interpretation pathway
Liver injury and failure pathway
High risk modifiers
Chronic alcohol use
Malnutrition
Enzyme inducing drugs
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.