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Investigations

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In a case of suspected paracetamol poisoning an emergency blood level should be taken, at least 4 hrs after ingestion.

The first sign of hepatic necrosis is prolongation of the prothrombin time:

  • a prothrombin time > 45 sec indicates severe liver damage
  • potentially fatal overdoses cause maximal derangement of the clotting system after 72 hr
  • a prothrombin time > 25 sec after 46 hr is prognostically ominous

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