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Salicylate Poisoning

Zachary Sartor, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Systemic disorder caused by acute and/or chronic intoxication from salicylate-containing medications including aspirin, bismuth salicylate, oil of wintergreen, topical medications, a...

DIAGNOSIS

HISTORY

  • Time of ingestion

  • Type of ingestion (What product? Any co-ingestions?)

  • Duration of use

  • Amount of ingestion

  • Additional medical history (co-morbidities such as underlying cardiac or renal d...

TREATMENT

MEDICATION

  • Manage ABCs; ensure airway protection given the risk of mental status changes, respiratory failure, and acidosis.

    • Maintain high tidal volume and respiratory rate if intubation is re...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Check blood gases and salicylate levels every 1 to 2 hours until two consecutive improvements.

  • Blood glucose, electrolytes, renal function

  • Psychia...

REFERENCES

1
Gummin DD, Mowry JB, Beuhler MC, et al. 2019 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 37th Annual Report. Clin Toxicol. 2020...

ADDITIONAL READING

Shively  RM, Hoffman  RS, Manini  AF. Acute salicylate poisoning: risk factors for severe outcome. Clin Toxicol (Phila).  2017;55(3):175–180. [View Abstrac...

CODES

ICD10

  • T39.014A Poisoning by aspirin, undetermined, initial encounter

  • E87.2 Acidosis

  • T39.011A Poisoning by aspirin, accidental (unintentional), init

  • T39.012A Poisoning by aspirin, intentional self-ha...

CLINICAL PEARLS

  • Consider salicylate toxicity with mixed metabolic acidosis and respiratory alkalosis, especially if an anion gap is present.

  • Activated charcoal within 2 hours (ideally 1 hour) of toxic ...

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