Acetyl Salicylic Acid (Aspirin) and other Salicylates Poisoning

• 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

Prevention

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

Do’s

• 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

Don’ts

• 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

References

1. STG

2. Tyler J. Runde; Thomas M. Nappe. https://www.ncbi.nlm.nih.gov/books/NBK499879/ July 13, 2020. [PubMed]