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WikiTox » Problems for Discussion- 1- Salicylates

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Salicylates


Objectives

  • Understand the mechanism and treatment of salicylate poisoning
  • Understand effects of urinary alkalinisation

Problem 1


An 18-year-old girl, 60 kg, 5 hours previously ingested 80 x 300 mg soluble aspirin washed down with a large amount of cheap wine. She is nauseated, vomiting complains of buzzing in her ears. Drowsy but responds purposefully. Pulse 120, BP 105/60, RR 18
You order some investigations
  • Breath Alcohol 0.16
  • Glucose 6.4 mmol/L
  • ABGs
    • pH 7.32
    • pCOB2B 28
    • pOB2B 112
    • HCOB3B 13
  • Electrolytes Normal
  • Urine pH 6

  1. Would you decontaminate her?
  2. Discuss her management, detailing your interventions and how you would monitor therapy.
  3. What is the implication of co-ingestion of alcohol (or other sedatives) in this situation?

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