Posted by: medicblog999 | February 14, 2009

So Sad!

 paracetamol

Last year, I was sent to a local hotel for a woman who had taken a paracetamol overdose.

Nothing new there then, just another overdose, someone in need of some TLC and a run up to Accident and Emergency for a blood test, maybe a parvolex infusion, a review by the psychiatrists and sent home.

We arrive on scene and are shown to a room where we meet the patient, Susan (not her real name). Susan is approximately 35 yrs old and really doesnt look very well, and not in the usual intoxicated manner that we frequently see overdoses. She just really looks poorly.

My partner does a quick set of obs, all within the normal range, but verging on slightly tachycardic and slightly hypotensive for age, whilst I move on with the assessment. I ask all of the usual overdose related questions:

M999: “What have you taken?”

Susan: “Paracetamol”

M999: “How many did you take and what time did you take them?”

Susan: “100 and 2 days ago”

How many???, When ???. Oh crap!!

Paracetamol overdose is THE most common overdose that I see. It is easily and freely available for minimal cost and most people see it as a safe option for taking an overdose when deep down they don’t actually want to die. Paracetamol overdose is VERY easily treated, even when significant amounts have been ingested, as long as the patient receives treatment within a specific time frame.

Having ingested 100 tablets 2 days ago is a really different matter!

M999: “2 days ago? Why have you waited so long to call us?”

Susan: “I want to die, I don’t want to live anymore. I knew if I left it long enough, there would be nothing anyone could do. Ive only called you now because the pain is starting to become unbearable and I feel so unwell. I don’t think I have long left and I don’t want one of the staff to have to find me.”

Susan obviously knew what she was doing and seemed very informed on paracetamol overdose and how long to leave things for it to be fatal, which begged the question:

M999: “Susan, what do you do for a living?”

Susan: “I’m a Sister in Accident and Emergency in London.”

M999: “You know exactly what you are doing don’t you Susan?”

Susan: “Yeah, Ive come up here so that I don’t get taken to my own hospital. I don’t want my friends to see me like this and I don’t want my family to have to go through whats coming. They can be informed after I am dead.”

Wow, to say I was gobsmaked is an understatement. Here I was standing in front of a very attractive young lady. Good career, apparently with lots of friends who care about her, who has planned her suicide to perfection. This was no cry for help. She knew exactly how long to leave things before calling for help, the pain that she was experiencing was her liver necrosing and the rest of her body going into multi-organ failure.

There is no coming back from this, even the possibility of a liver transplant would have probably been to late.

All that was left to do for her was to move her to the ambulance, give her some morphine for her pain to try and make her more comfortable and get her into hospital.

It was really strange to be rushing someone in on blue lights and sirens when you know that they are dying but that is what they want. The only thing that could be done for her now was to ensure that her last few hours were comfortable and she didn’t suffer too much.
Death from paracetamol poisoning is not a nice way to die. Some people say suicide is a selfish act, and in alot of cases I tend to agree.
I have seen the aftermath when someone jumps off a bridge and lands in front of a car with a family sitting horrified in it. I have seen a mother and daughter open a door to see their husband/father hanging from the loft and I have seen the effect on train drivers when they have to cope with running over someone lying on the tracks.

Susan was different, she took all the steps she could to ensure that no one was hurt more than absolutely needed by her desire to die. Her friends didn’t have to look after her and watch her die and a member of hotel cleaning staff did not have to find a dead body lying in the bed the next day.
How it affected her family is another matter, I’m sure they would have wanted to be with her during her last few hours so they could say their goodbyes but I guess Susan was doing what she thought was less painful for them.

I have nothing but respect for how she handled herself and the thought that she had put into everything. It’s just such a pity that it has to come to that for some people.

 

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Responses

  1. I can’t believe she hadn’t puked out her whole blood volume by that time. Wow.

  2. That was a very, very sad story.

  3. that is a very sad story, did she live?

    • Unfortunately not. She died a couple of days later.


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