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Aspirin Poisoning

Medications continued...

IV fluids: Dehydration occurs early in aspirin poisoning. To correct dehydration, the doctor will start an IV to correct this imbalance. The doctor will also work to correct imbalances in the body's blood chemistries.

Alkaline diuresis: This is a way to reduce the amount of salicylate in the body. Alkaline diuresis is the process of giving a person who has been poisoned compounds that alter the chemistry of the blood and urine in a way that allows the kidneys to remove more salicylate. Specifically, sodium bicarbonate is given via IV to make the blood and urine less acidic (more alkaline), which encourages the kidneys to capture more salicylate that can leave the body through the urine. Sometimes, other compounds, such as potassium, also have to be given to help with this process.

Other Therapy

The emergency physician may have to perform other procedures or give other medications as supportive care in the case of dangerous aspirin overdose. These actions may include the following: 

 

  • Placing a breathing tube (intubation) and assisting breathing with a ventilator for a person who is agitated, in a coma, who cannot protect their own airway, or for whom mechanical breathing could be helpful

  • Placement of a catheter into the bladder to monitor urine output and frequently check the acidity (pH) of the urine

  • Administration of other medications as may be needed to treat agitation, convulsions (seizures), or other complications of aspirin poisoning

Next Steps

  • Admit patients with major signs and symptoms (for example, neurological, cardiopulmonary, and metabolic) to an intensive care unit under the care of a medical toxicologist, if available. Consult psychiatric service personnel for patients with intentional overdose.

  • Admit patients with minor signs and symptoms (for example, tinnitus and nausea) to an extended care observational unit or medical floor.

  • Admit the following patients, regardless of salicylate levels:

    • Infants and elderly persons

    • Individuals with long-term salicylism

    • Those with ingestions of sustained-release products

Follow-up

People with acute, single ingestions of non—enteric-coated aspirin of less than 150 mg/kg who have no symptoms and have a nontoxic aspirin level after 6 hours may be released from the hospital. All others with aspirin poisonings will likely be treated in the emergency department, then hospitalized for further treatment and observation.

  • Psychiatric and medical follow-up may be recommended.

  • Careful monitoring of medication intake will be recommended as well.

  • Tests to monitor kidney function may be done periodically after hospital discharge, especially in elderly people.

Prevention

Prescription medications should be used according to your doctor's and pharmacist's directions.

  • Never take a medicine prescribed for someone else.

  • To protect children from accidental drug overdose, all medications should be stored in containers with child-resistant caps. All medications should be out of sight and out of reach of children, preferably in a locked cabinet.

  • Take suicidal threats seriously.

  • Never give or take medication in the dark.

  • Always tell the doctor of any previous side effects or adverse reactions to medication as well as any new or unusual symptoms that occur.

  • Never take more than the recommended or prescribed dose of a medication.

  • Inform your doctor about all the medications you are taking. Be sure to mention over-the-counter medications.

WebMD Medical Reference from eMedicineHealth

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