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Warning-sign checks

Acetaminophen and codeine overdose: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek emergency care after discharge for new or worsening trouble breathing, inability to stay awake, confusion, fainting, repeated vomiting, yellow skin or eyes, severe abdominal pain, unusual bleeding, or markedly reduced urination.

    And for anyone, someone who:

    • is unconscious, or cannot be woken
    • you believe has taken an overdose or swallowed something poisonous
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
  2. 2

    Is any of this happening?

    Be seen today

    Urgent help is appropriate if thoughts of self-harm return or the person may not remain safe.

  3. 3

    Does any of this apply?

    Book an appointment

    Follow-up depends on the amount and pattern of exposure, test results, symptoms, and treatments received.

    Some people can leave the hospital after an appropriate observation period and reassuring tests.

    Others need repeated blood tests, longer monitoring, or specialist care.

    A routine medication review can help prevent another accidental overdose.

    This should include prescription medicines, nonprescription pain relievers, and cold or flu products.

    Patients and caregivers can ask a pharmacist to identify products that contain acetaminophen or cause sedation.

    These are not symptoms to save for a routine appointment.

    And for anyone, someone who:

    • is having side effects from a medicine, or is struggling to take it as prescribed

The article also says

After discharge, attend all scheduled appointments and laboratory testing.

A clinician may need to confirm that liver tests, kidney function, and blood-clotting measurements are improving.

Do not restart medicines containing acetaminophen, codeine, or other opioids until the treating clinician says it is appropriate.

If the overdose was connected to self-harm, follow the safety plan made with the care team.

Every sign above is quoted from the sofidex article on Acetaminophen and codeine overdose. If you are not sure, err upward — it is always reasonable to be checked.