PASTIME

Salicylate poisoning, also known asaspirin poisoning, is the acute or chronic poisoning with asalicylatesuch asaspirin.The classic symptoms areringing in the ears,nausea,abdominal pain, and afast breathing rate.Early on, these may be subtle, while larger doses may result infever.Complications can includeswelling of the brainorlungs,seizures,low blood sugar, orcardiac arrest. While usually due to aspirin, other possible causes includeoil of wintergreenandbismuth subsalicylate.Excess doses can be either on purpose or accidental.Small amounts of oi‍​‍‍‍​‍‍‍‍‍‍‍‍​‍l of wintergreen can be toxic.Diagnosis is generally based on repeated blood tests measuring aspirin levels andblood gases.While atype of graphhas been created to try to assist with diagnosis, its general use is not recommended.In overdose maximum blood levels may not occur for more than 12 hours. Efforts to prevent poisoning includechild-resistant packagingand a lower number of pills per package.Treatment may includeactivated charcoal, intravenoussodium bicarbonatewithdextroseandpotassium chloride, anddialysis.Giving dextrose may be useful even if theblood sugaris normal.Dialysis is recommended in those withkidney failure,decreased level of consciousness, bloodpHless than 7.2, or high blood salicylate levels.If a person requiresintubation, afast respiratory ratemay be required. The toxic effects of salicylates have been described since at least 1877.In 2004, more than 20,000 cases with 43 deaths were reported in the United States.About 1% of those with an acute overdose die, while chronic overdoses may have severe outcomes.Older people are at higher risks of toxicity for any given dose.