Acute Caremiddle twist
A 17-year-old girl weighing 55 kg says she swallowed 45 tablets of immediate-release paracetamol 500 mg about ten hours ago after an argument with her partner. She has vomited twice, is alert with no abdominal tenderness, and takes no other medication. She denies any other ingestion. The laboratory reports a two-hour turnaround for paracetamol concentrations. Which one of the following acetylcysteine plans is most appropriate?