CHAPTER 84 The Rumack–Matthew Nomogram: Acetaminophen Poisoning and Toxicity

Acetaminophen Poisoning and Toxicity

Rumack BH, Matthew H. Pediatrics. 1975;55(6):871–876

BACKGROUND

Acetaminophen toxicity is insidious, leading to varied outcomes ranging from spontaneous recovery to fulminant hepatic failure. In 1975, Rumack and Matthew performed the first and to date largest observation study investigating the prognostic value of serum acetaminophen levels over time in predicting hepatotoxicity in untreated overdoses. Previous works had established that if at 12 hours postingestion acetaminophen levels were <50 mcg/mL, there was a very low likelihood of hepatic injury. This study was addressing missing information in prognosis as N-acetylcysteine (NAC) had not yet been discovered at the time of this study.

OBJECTIVE

To correlate serum acetaminophen levels over time with outcomes of hepatotoxicity in untreated cases of acetaminophen intoxication.

METHODS

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