【Rumack-Matthew nomogram】The original nomogram line separating possible toxicity from unlikely toxicity was based on a 4-hour ACT level of 200 micrograms/mL (1300 micromoles/L), but was subsequently modified in the U.S. by the FDA by moving the line to a 4-hour ACT level of 150 micrograms/mL (1000 micromoles/L) to increase the safety ⋯⋯margin for treatment decisions. The nomogram only directly applies to an ACT level obtained after a single exposure and during the window between 4 and 24 hours postingestion. Outcome prediction using this nomogram cannot be applied to ACT levels obtained outside this 20-hour window or with chronic or recurrent exposures.


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