Salicylate Toxicity - Diagnosis and Management



Consider if:

1) Patient is hot and altered

2) You see tachypnea with no respiratory cause

3) Labs show anion-gap metabolic acidosis

4) Presentation seems like DKA, sepsis, PNA, meningitis

5) History of acute or chronic ingestion/exposure



Symptoms: Nausea, Vomiting, Tinnitus, Hearing loss, Dizziness, Altered, Seizure, Coma

Exam: Tachypnea, Tachycardia, Elevated temp, Diaphoresis, Pulmonary edema, Shock

Labs: Anion-Gap Metabolic Acidosis, Respiratory Alkalosis, High Lactate, Low Potassium, Low Glucose, Salicylate level

  - Toxic Salicylate Level: 150mg/kg



Management:

1) Resuscitation

2) Urine pH > 7.5 with Alkalinzation

3) Glucose > 4.5 mmol/L

4) K > 4.5 mmol/L

5) Dialysis



By Sarah Foohey @SarahFoohey



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