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Acetyl Salicylic Acid (Aspirin) and other Salicylates Poisoning



Salicylates Poisoning is a medical emergency. Intentional ingestion or accidental overdose can cause severe metabolic derangements making treatment difficult. Co-ingestion of other medications can further complicate management.

Risk Factors

Signs and symptoms

Diagnostic criteria

Initial signs and symptoms

• Tinnitus
• Impaired hearing
• Rapid breathing (acidotic-like breathing)
• Vomiting
• Dehydration
• Fever
• Double vision
• Feeling faint

Late signs

• Drowsiness
• Bizarre behavior
• Unsteady walking
• Coma


• Blood gases
• pH and bicarbonates
• Serum electrolytes


  • Non-pharmacological

    • Give activated charcoal within one hour of ingestion if available. If charcoal is not available and a severely toxic dose has been given, then perform gastric lavage or induce vomiting as above
    • Replace fluid losses (Plasma potassium concentration should be corrected before giving sodium bicarbonate as hypokalaemia may complicate alkalinisation of urine)
    • Monitor blood glucose every 6 hours and correct as necessary
    • Monitor urine pH hourly.
  • Pharmacological

    Sodium bicarbonate (IV) 1 mmol/kg over 4 hours to correct acidosis and to raise the pH of the urine to above 7.5 so that salicylate excretion is increased.

    • Give 0.9% sodium chloride as maintenance requirements
    • Hemodialysis is required if the concentration exceeds 700mg/liter or in presence of severe metabolic acidosis


Educate the patient on Dos and Don’ts of poisoning prevention.


• Keep medicines and poison in proper containers and out of reach of children
• Use containers with child resistant caps
• Keep all products in their original container
• Read medicine labels carefully to avoid mistake


• Leave container open
• Transfer products from their origin
• Remove labels from the medicine products
• Put tablets into another containers such as purse or envelope
• Medicine/tablets as sweet
• Take your medicine in front of children as they often copy

Updated on,

14 Novemba 2020 15:01:40


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