Salicylate poisoning

T39.0 + (X40.99/X60.99/Y10.99)

• Description
• General measures
• Medicine treatment
• Referral

DESCRIPTION

Mild to moderate toxicity:

• Nausea, vomiting, tinnitus, fever, tachypnoea and respiratory alkalosis

Severe toxicity:

• Metabolic acidosis, altered mental status, seizures, coma, non-cardiogenic pulmonary oedema.

Note: Wintergreen oils/ ointments contain 98% methyl salicylate.

GENERAL MEASURES

• Assess severity with history, clinical examination and salicylate levels if possible.
• Correct hydration.
• Consider ICU admission for pulmonary and/or cerebral oedema.

MEDICINE TREATMENT

• Salicylates delay gastric emptying, therefore activated charcoal may be effective for a longer period than usual.
• Whole bowel irrigation maybe useful for enteric-coated or modified-release preparations.

LoEIII [25]

Treat acidosis and enhance renal excretion:

• Sodium bicarbonate, IV and urinary alkalinisation (blood pH 7.45-7.5 and urine pH 7.5–8.5) in consultation with specialist and arrange for transfer.

LoEIII

REFERRAL

Where acidosis does not respond rapidly to sodium bicarbonate, refer for haemodialysis.

LoEIII [26]