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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Plot acetaminophen concentration on Rumack-Matthew nomogram see above. Acetaminiphen you continue using our website, we’ll assume that you are happy to receive all cookies on this website. Screening and testing for paracetamol in the first 24 hours is necessary as patients are asymptomatic with toxic doses.

A formal half life may also be determined. NAC is continued beyond the 20 hours infusion until paracetamol is undetectable. Loves the misery of alpine climbing and working in austere environments.


Smilkstein MJ, 11, cases of suspected acetaminophen overdose; described outcomes of 2, cases treated with 72 hour oral N-acetylcysteine. There I said it. Applies only to single acute paracetamol ingestions of immediate-relate 2. Views Read Edit View history. To save favorites, you must log in. Notify me of new posts by email. We are actively recruiting both new topics and authors.

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

Rather, a second level should be drawn and plotted to see if the slope of the line remains at or above the nomogram. Patients should address specific medical concerns with their physicians.

Lexi-Comp Accessed Aug It is the practise of some clinical toxicologists to increase the acetylcyteine dose. Lexicomp Online [online database]. Serious to lethal hepatotoxicity History Findings: Her weight is 54 kg. NAC treatment should be initiated within 8 hours post-ingestion to decrease risk of hepatotoxicity.

If paracetamol concentration result can be determined before 8 hourswait, plot against the nomogram and treat as appropriate. Either the patient refuses to acetamniophen you, you have doubts about the timing or they are in a coma and paracetamol is detectable, start NAC. Equally do not discharge the symptomatic patient, you may have miss timed the point of ingestion or the patient may have lied to you about time or co-ingestants.

What if the patient present at 8 hours, 12 hours or 24 hours. From Wikipedia, the free encyclopedia. Please fill out required fields. Supporter of Acetaminopjen, tox, sim, ultrasound and any other project that can distract me for 5 seconds This nomogram is not used alone if the patient has altered mental status or if the history is not reliable.


Absence of formulations or coingestants that alter absorption and bowel motility e. Mar 29th, Maryam Abdrabbo categories: Archives of Internal Medicine.

Rumack-Matthew nomogram – Wikipedia

NAC is only indicated if the patient is symptomatic nomogdam, vomiting, abdominal pain or encephalopathy or a detectable paracetamol concentration or raised hepatic transaminases. Unknown time of ingestion: 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.

It is highly recommended to consult with a poison control center or medical acetwminophen when considering the discontinuation of acetylcysteine prior to the conclusion of a full course of therapy. Notify me of follow-up comments by email. If results are abnormal continue 20 hour NAC infusion. About the Creator Barry H.

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