Salicylate (Aspirin) Poisoning

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Adults

• Gastric emptying is delayed
• Always empty the stomach
• Give repeated doses of Activated Charcoal to delay absorption of any remaining poison (See Section on swallowed poisoning, activated charcoal administration)
• Watch for and treat hypoglycemia, convulsions, and metabolic acidosis

In severe cases:

• Darrow's ½ strength in Dextrose 5% infusion with added Sodium Bicarbonate (30 mmol/litre) or Ringers Lactate may be needed to increase renal excretion

Children

• Give activated charcoal (1 g/kg) if within 4 hours of ingestion
• “Forced alkaline diuresis” is no longer advised in children due to risks of fluid overload Maintain a good urine flow of around 1ml/kg/hour
• Can use sodium bicarbonate to alkalinize urine in severe cases (1mmol/kg NaHCO3 over 4 hours – IV or oral)