![]() Activated Charcoal for Acute Poisoning: One Toxicologist’s Journey. Extracorporeal Treatment for Salicylate Poisoning: Systematic Review and Recommendations From the EXTRIP Workgroup. Juurlink DN, Gosselin S, Kielstein JT, et al.Activated charcoal effectively binds acetaminophen, aspirin, and tricyclic antidepressants. Toxicity Antidote/management Acetaminophen: Formation of toxic metabolite in the liver. An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose. Poisoning occurs when a substance that is inhaled, ingested, or absorbed through the skin has harmful effects or even causes death. None of the other individuals in control of the content for this article reported relevant financial relationships with ineligible companies.įor details, please review our full conflict of interest (COI) policy. Jan Schlebes (medical editor, is a shareholder in Fresenius SE & Co KGaA). All of the relevant financial relationships listed for the following individuals have been mitigated: $Contributor Disclosures - Salicylate poisoning.Guidance Document: Management Priorities in Salicylate Toxicity. American College of Medical Toxicology.Continuous cardiac monitoring, continuous pulse oximetry, frequent neurological checksĪcute management checklist for salicylate poisoning.Serum salicylates (until consistently Continuous bicarbonate in D5W to achieve and maintain urine alkalization.Consider bicarbonate loading dose, especially if arterial pH The ingested aspirin dose is known to be > 500 mg/kg.Salicylate combinations with other substances (like opioids) can lead to mixed intoxications that require specific management (e.g., naloxone). Intubating patients with salicylate poisoning is dangerous! If intubation is required, extra care should be taken to maximize minute ventilation, as there is a high risk of worsening acidosis and death. Serum salicylates > 90 mg/dL ( > 80 mg/dL if renal function impaired) or arterial pH ≤ 7.2 despite supportive care.Serum salicylates > 100 mg/dL ( > 90 mg/dL if renal function impaired).Indications for hemodialysis in salicylate poisoning Indications for intubation in salicylate poisoning Maximize minute ventilation (e.g., at least 8–10 mL/kg/breath).Administer bicarbonate prior to intubation.Evaluate the need for intubation but avoid intubation, if possible.For symptomatic patients: Consult ICU, nephrology, and toxicology.Assess the severity of salicylate poisoning (see salicylate poisoning severity above).She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services. ![]() She has no stock options or shares in any pharmaceutical or healthcare companies however, she invests in a personal pension, which may invest in these types of companies. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others and communications agencies, including Publicis, Red Healthcare and others. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. Similar toxicity can occur after exposure to cardioactive steroids in plants such as oleander, red squill, or dogbane or from animals such as Bufo toads. ![]() ![]() If inducing vomit is necessary, your vet or the pet poison control line will walk you through the proper steps. Inducing vomiting can remove aspirin from your dog’s stomach before its body has the chance to absorb it. SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. Digoxin toxicity can present acutely, by an intentional or accidental overdose (i.e., therapeutic misadventure), or chronically, such as when patients on digoxin develop an acute kidney injury. Induce vomiting to force the aspirin from the dog's stomach. Lead Section Editor, BMJ Best Practice Disclosures
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