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Salicylate Poisoning

Dana J. Kamenetsky, MD and Chi Huang, MD, SFHM, FACP Reviewed 06/2019
 


BASICS

DESCRIPTION

Systemic disorder caused by acute and/or chronic intoxication from salicylate-containing medications 
  • Following accidental or intentional ingestion, toxic actions of salicylates inclu...

DIAGNOSIS

PHYSICAL EXAM

  • Signs and symptoms differ in acute and chronic intoxications.

  • Acute intoxication (adults)

    • Symptoms vary with amount ingested. Onset usually within 4 to 8 hours of ingestion. Ent...

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 ...

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
Juurlink DN, Gosselin S, Kielstein JT, et al; for EXTRIP Workgroup. Extracorporeal treatment for salicylate poisoning: systematic review and recommendations from the EXTRIP workgroup. Ann ...

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 Abstract on OvidMedline] 

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

  • Gastric decontamination should be performed only in potentially life-threatening ingestions.

  • Consider salicylate toxicity with mixed metabolic acidosis and respiratory alkalosis, especi...

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