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. Author manuscript; available in PMC: 2009 Feb 9.
Published in final edited form as: N Engl J Med. 2008 Jul 17;359(3):285–292. doi: 10.1056/NEJMct0708278

Figure 2. The Rumack–Matthew Nomogram.

Figure 2

The Rumack–Matthew nomogram, first published in 1975, was developed to estimate the likelihood of hepatic injury due to acetaminophen toxicity for patients with a single ingestion at a known time. To use the nomogram, the patient’s plasma acetaminophen concentration and the time interval since ingestion are plotted. If the resulting point is above and to the right of the sloping line, hepatic injury is likely to result and the use of acetylcysteine is indicated. If the point is below and to the left of the line, hepatic injury is unlikely. Patients with repeated supratherapeutic ingestion, or with an unknown time of ingestion, cannot be evaluated with the use of the Rumack–Matthew nomogram.