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Aspirin and Other Salicylate Poisoning
Diagnosis of Salicylate Poisoning
Serum salicylate level Arterial blood gases (ABGs) Salicylate poisoning is suspected in patients with any of the following: History of a single acute overdose Repeated ingestions of therapeutic doses Unexplained metabolic acidosis Unexplained confusion and fever (in older patients) Other findings compatible with Sepsis and Septic Shock (eg, fever, hypoxia, noncardiogenic pulmonary edema, dehydration, hypotension) nitrogen (BUN) are measured. If Rhabdomyolysis is suspected, serum creatine kinase (CK) and urine myoglobin are measured. Significant salicylate toxicity is suggested by serum levels much higher than therapeutic (therapeutic range, 10 to 20 mg/dL [0.725 to 1.45 mmol/L]), particularly 6 hours after ingestion (when absorption is usually almost complete), and by acidemia plus ABG results compatible with salicylate poisoning. Serum levels are helpful in confirming the diagnosis and may help guide therapy, but levels may be misleading and should be clinically correlated. Usually, ABGs show primary Respiratory Alkalosis during the first few hours after ingestion; later, they show compensated 