his serum sodium concentration had increased from 142 mmol/L to 165 mmol/L. Soluble paracetamol was withdrawn shortly before he died, and was believed to have contributed to his hypernatremia.

A suspension formulation was substituted and the paracetamol was withdrawn over the next 3 days. His serum sodium concentration stabilised at 161, 159, and 160 mmol/L over these 3 days.

Massive paracetamol overdoses that result in high paracetamol concentrations more than double the paracetamol nomogram line should be managed with an increased dose of acetylcysteine. 3.

previous episode of serum potassium 5.0 mmol/L or higher within 3 months, heart failure, diabetes, and metabolic acidosis as independent risk factors. Dr Xue and his team developed a nomogram ...