injuries poisoning
Aspirin and Other Salicylate Poisoning
Introduction
Salicylate poisoning can cause vomiting, tinnitus, confusion, hyperthermia, respiratory alkalosis, metabolic acidosis, and multiple organ failure. Diagnosis is clinical, supplemented by measurement of the anion gap, arterial blood gases, and serum salicylate levels. Treatment is with activatedcharcoaland alkaline diuresis or hemodialysis. (See also General Principles of Poisoning .) 150 mg/kg of salicylate can cause severe toxicity. Salicylate tablets may form Bezoars , prolonging absorption and toxicity. Chronic toxicity can occur after several days or more of high therapeutic doses; it is common, often undiagnosed, and often more serious than acute toxicity. Chronic toxicity tends to occur in older patients. The most concentrated and toxic form of salicylate is oil of wintergreen (methyl salicylate, a component of some liniments and solutions used in hot vaporizers); ingestion of<5 mL is equivalent to about 7000 milligrams (twenty-two 325-mg tablets) ofaspirin, which can kill a young child. Any exposure should be considered serious.Bismuth subsalicylate(8.7 mg salicylate/mL) is another potentially unexpected source of large amounts of salicylate. Ingestion of<5 mL of oil of wintergreen (methyl salicylate, a component of some liniments and solutions used in hot vaporizers) can kill a young child. 