A 19-year-old woman presents six hours after taking 30 × 500 mg paracetamol tablets in a single impulsive act following an argument. She also took "a few" ibuprofen. She is tearful but alert, with normal vital signs, and has vomited once. A serum paracetamol concentration taken at six hours post-ingestion is 920 µmol/L; the nomogram treatment line at six hours is 700 µmol/L. Liver function tests and INR are normal.
Which one of the following is the most appropriate management?
Keep going — a set of ten like this one, one at a time.
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