[onehusbandsevenkids]

I posted this in response to the othe tylenol OD post and would like some feedback. Here's what I posted on page 4 of the original tylenol od thread:


Wow, how ironic...I was just in the ED with my best friend who did the same thing!

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She took 30 Tylenol Pm and 2 Loritabs. Was sick all night long. Didn't tell anyone until two days later. On day 5 after ingestion, she told me and we looked up tylenol toxcity and she got scared. She called poison control, they told her to immediately go to the ED, that they were calling ED to expect her and how long until she would arrive.

She was examined, blood taken, IV fluids given. Started the NAC IV about an hour or so after we arrived. Within 5 mins she started to react. Very flushed, itchy, eyes feeling dried out, tongue swelling. I get nurse (for some reason there are no call buttons anywhere in the ED???) Nurse comes in, turns off NAC, says she's going to have the Dr come in. We wait. And wait. Probably about a good 20-25 mins. Friend's reaction getting much worse, hives all over, out of her mind itchiness, face, neck and body swelling, tongue swelling even more and getting jagged looking bumps on the sides of it. Eyes about swollen shut, can't talk due to swollen tongue.All of this happened very quickly. I run to find the nurse, can't find anyone but cleaning staff (in a large city ED). Finally find nurse, she freaks....shoots 3 syringes of epinephrine into her, oxygen, leads, ect...move her out to in front of their station window.
She finally stabilizes. She gets moved into another ED room. We sit there for 3 hours and no one comes in for anything (well except for cleaning people) the nurses and docs pass us in the room constantly, no one comes in.
Finally psych doc comes and talks to friend for a while. Convinces her to check in for a few days to the local psych hospital.
We were in this ER for 10 hours...ugh.

An ED doc comes in later and says that they feel there would be no long term damage to her liver and she is free to go. They draw two more tubes of blood, very hard for the nurse to do from the IV site since the othe nurse never returned to fluch the IV. She's discharged to immediately be driven to be admitted to the psych hospital where she is now.

So, I'm wondering...she took 30 - 500mgs each with 25mgs benedryl each....everyone here is talking about how dangerous it is and the ED says she is fine, no damage? Hmmmm..... What these docs said and what the docs from the OP's sisters situation don't really seem to jive....
But what do I know, I'm just a nursing student!

[mommatrauma]

Sorry you had a bad experience in the ED...Being that I work in a busy city ER I can imagine it happens more often than not...5 days out...if there was any damage done to the liver, its pretty much done and nothing you can do about it now...They probably started the NAC because they had no levels back yet on the off chance your friend still had elevations...Sounds like she had a bad reaction to it, which usually happens right away like it did, if its going to happen at all...3 syringes of epi???? Thats a little much...Even for a severe reaction...As for sitting in the ER, it does take a while to get the results back, not to mention that they probably needed to keep your friend there due to the reaction that was had to the NAC...The fact that they told you no long term liver damage, probably means that your friend is lucky...and that the LFT's came back normal...The follow up liver studies are to make sure nothing changes a little further down the road, but 5 days out the tylenol taken should have been fully metabolized by a healthy liver therefore no longer effecting the body...Hope your friend is feeling better and getting the needed help.