A toxic exposure to acetaminophen is suggested when a patient ≥6 years old ingests

(1) >10 grams or 200 milligrams/kg as a single ingestion,

(2) >10 grams or 200 milligrams/kg over a 24-hour period, or

(3) >6 grams or 150 milligrams/kg per 24-hour period for at least 2 consecutive days. For children <6 years old, ingestion of 200 milligrams/kg or more of acetaminophen as a single ingestion or over an 8-hour period, or of 150 milligrams/kg per 24-hour period for the preceding 48 hours is considered a toxic exposure. These values are empiric and not validated in human trials, but they are widely used as recommendations for emergency evaluation. Even though a patient's history of the amount ingested may be unreliable, a patient report of >10 to 12 grams ingested was associated with a 4-hour acetaminophen concentration above 150 micrograms/mL (1000 micromoles/L) in 40% to 70% of toxic exposures.29,30










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