injuries poisoning
Aspirin and Other Salicylate Poisoning
Treatment of Salicylate Poisoning
Activatedcharcoal Alkaline diuresis with extrapotassium chloride Unless contraindicated (eg, by altered mental status), activatedcharcoalis given as soon as possible and, if bowel sounds are present, may be repeated every 4 hours untilcharcoalappears in the stool. 8. Alkaline diuresis is indicated for patients with any symptoms of poisoning and should not be delayed until salicylate levels are determined. This intervention is usually safe and exponentially increases salicylate excretion. Because Hypokalemia may interfere with alkaline diuresis, patients are given a solution consisting of 1 L of 5% D/W, 3 50-mEq (50-mmol) ampules of ) should be avoided because they worsen Metabolic Acidosis and decrease blood pH. Drugs that decrease respiratory drive should be avoided if possible because they may impair hyperventilation and Fever can be treated with physical measures such as Cooling techniques . Seizures are treated with benzodiazepines. In patients with Hemodialysismay be required to enhance salicylate elimination in patients with severe neurologic impairment, renal or respiratory insufficiency, acidemia despite other measures, or very high serum salicylate levels (>100 mg/dL [>7.25 mmol/L] with acute overdose or>60 mg/dL [>4.35 mmol/L] with chronic overdose). Treating acid-base alterations in salicylate-poisoned patients who require endotracheal intubation and mechanical ventilation for airway protection or oxygenation can be extremely challenging. In general, intubated patients should probably be dialyzed and closely monitored by a critical care specialist. 