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.

Author: Dainos Shakagor
Country: Egypt
Language: English (Spanish)
Genre: Automotive
Published (Last): 10 January 2005
Pages: 249
PDF File Size: 2.90 Mb
ePub File Size: 19.99 Mb
ISBN: 443-3-25763-718-1
Downloads: 86480
Price: Free* [*Free Regsitration Required]
Uploader: Yozshudal

Calc Function Calcs that help predict probability of a disease Diagnosis. Analysis of the National Multicenter Study. IR — majority is absorbed within 2 hours.

Acetaminophen Toxicity

Serum acetaminophen concentration should nomogtam sent in all patients presenting with intentional overdose or those using excessive amounts of acetaminophen containing products. New Guidelines for the management of paracetamol poisoning in Australian and New Zealand.

This was published in This page was last edited npmogram 12 Octoberat Plot a single [APAP] onto the nomogram. 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.

By using this site, you agree to the Terms of Use and Privacy Policy. Notify me of follow-up comments by email. Nelson LS, et al Eds. Related links to external sites from Bing. Get an accurate time of ingestion: Not validated aceatminophen 4 hours or after 16 hours 4. Archives of Internal Medicine.


Presentation within 24 hours: A formal half onmogram may also be determined. Key Points to remember: Search other sites for ‘Acetaminophen Toxicity’. Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose: If results are abnormal continue 20 hour NAC infusion. We are actively recruiting both new topics and authors.

Lexicomp Online [online database]. This allows for the worst case scenario. It is a logarithmic graph starting not directly from ingestion, but from 4 hours post ingestion after absorption is considered likely to qcetaminophen complete.

Tarascon Adult Emergency Pocketbook.

Acetaminophen Overdose and NAC Dosing – MDCalc

Med treatment and more Treatment. Treatment should begin within 8 hours of ingestion or as soon as possible after ingestion.

Rather, a second level should be drawn and plotted to see qcetaminophen the slope of the line remains at or above the nomogram. If above treatment line, NAC is indicated.

May be given PO or IV.

Patients should address specific medical concerns with their physicians. Normally paracetamol is conjugated with glucuronide and excreted in the urine.

It has a prolonged absorption phase with peak concentration occurring within hours but maybe delayed up to 20 hours in overdose. A cetaminophen APAP nomovram in different strengths and formulations. NAC is only indicated if the patient is symptomatic nausea, vomiting, abdominal pain or encephalopathy or a detectable paracetamol concentration or raised hepatic transaminases.


Critical Actions Serum acetaminophen concentration should be sent in all patients presenting with intentional overdose or those using excessive amounts of acetaminophen containing products. But what about extended release, what if they have co-ingestants, what if they took multiple does of paracetamol at different times?

Rumack-Matthew nomogram

Serious to lethal hepatotoxicity History Findings: Either the patient refuses to tell you, you have doubts about the timing or they are in a coma and paracetamol is detectable, start NAC. Start NAC and time anchor the paracetamol concentration to Each country has different nomograms and units — make sure you are using the correct one and correct scale From the Australian Society of Emergency Medicine Paracetamol Poster. Unknown time of ingestion Determine earliest possible time of ingestion: Diagram from MJA article: Beyond 24 hours the patient should be symptomatic therefore, start NAC if the patient has nausea, vomiting, abdominal pain or encephalopathy.