The Rumack-Matthew nomogram (the acetaminophen toxicity nomogram or acetaminophen nomogram), is used to interpret serum. The Rumack-Matthew nomogram uses the serum acetaminophen concentration, in relation to the time after ingestion, to assess potential. The Rumack-Matthew nomogram, also known as Rumack-Matthews nomogram or the acetaminophen nomogram is an acetaminophen toxicity nomogram.

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Paracetamol • Life in the Fast Lane • LITFL • Medical Blog

Content is updated monthly with systematic literature nomogrzm and conferences. EM Boards Survival Guide: We use cookies to understand site usage and to improve the content and offerings on our sites.

Rumack-Matthew Nomogram for Acetaminophen 1.

Accessed 22 Aug Med acetainophen and more Treatment. Formula Actual body-weight dosing, starting with loading dose and then variable rates depending on PO vs. In hands of skilled clinicians this nomogram allows for timely management of acetaminophen overdose.

Below are the most common presentations and how to manage them: Started inthis collection now contains interlinked topic pages divided into a tree of 31 specialty books and chapters.

TOXCard: Acetaminophen Toxicity and Management

Subcategory of ‘Diagnosis’ designed to be very sensitive Rule Out. This can be one of the causes for chronic APAP toxicities. Acute, single ingestions where entire ingestion occurs within an 8-hour period.


All patients above the nomogram line should be treated with NAC to decrease the risk of developing hepatotoxicity See Evidence. Our goal is nomogra, inform the global EM community with timely and high yield content about what providers like YOU are seeing and doing everyday in your local ED. IR — majority is absorbed within 2 hours. NAC treatment should be initiated within 8 hours post-ingestion to decrease risk of hepatotoxicity.

If above treatment line, NAC should be initiated within 8 hours post-ingestion. Sorry, your blog cannot share posts by email.

To save favorites, you must log in. This was published in Smilkstein MJ, 11, cases of suspected acetaminophen overdose; described outcomes of 2, cases treated with 72 hour oral N-acetylcysteine.

Serious to lethal hepatotoxicity Acetaminophen Overdosage Hepatoxic dose: Algorithm of the month Algorithm for the Management of Atrial Fibrillation. About the Creator Dr. A formal half life may also be determined. Diagram from MJA article: Efficacy declines after this point.

Related links to external sites from Bing. This allows for the worst case scenario. In these cases, start or continue NAC until the risk assessment can be refined using further biochemical parameters and paracetamol concentrations. Related Bing Images Extra: Supporter of FOAMed, tox, sim, ultrasound and any other project that can distract me for 5 seconds Concepts Injury or Poisoning T SnomedCT English Acetaminophen overdose disorderParacetamol overdose disorderoverdose acetaminophenacetaminophen overdoseoverdose paracetamolacetaminophen overdosesparacetamol overdoseParacetamol overdoseAcetaminophen overdose Spanish sobredosis de paracetamol trastornosobredosis de paracetamol.


Commence NAC infusion acetaminpohen. Her weight is 54 kg.

Acetaminophen Overdose and NAC Dosing – MDCalc

When in doubt, conservative management is recommended, particular if the patient co-ingested substances that might prolong absorption i. What if the patient present at 8 hours, 12 hours or 24 hours.

The study line which is now referred to as the treatment line was created starting at at 4 hours and is the usual line used in the United States to determine treatment of acetaminophen overdose. NAC continues until the paracetamol concentration is undetectable and hepatic transaminases are stable or falling and the patient is clinically improving.