Acetaminophen Overdose Assessment

Rumack-Matthew Nomogram

Draw APAP level at ≥ 4 hours post-ingestion. Treatment line starts at 150 µg/mL at 4 hours, halving every 4 hours. Levels above the line: start NAC (N-acetylcysteine). NAC is most effective within 8 hours. For unknown ingestion time or staggered overdose, treat empirically. Toxic dose: > 150 mg/kg or > 7.5g in adults.