Clinical picture:
* Poisoning by Aspirin is common as Aspirin is abundant in many homes.
* The patient should swallow at least more than 40 Aspirin tablets to reach intoxication level.
* CNS stimulation: Fever - sweeting - burning pain in stomach - bloody vomiting - delirium - hypercapnia.
* Followed by CNS depression: Drowsiness - coma - respiratory failure and cardiovascular failure.
Treatment:
1- Gastric lavage. 2- Purgatives. 3- Fluids and electrolytes. 4- Cardio-respiratory care. 5- Alkalinization of
urine. 6- Forced alkaline diuretics.
1- Gastric lavage (repeated):
Using activated charcoal or milk.
Do not use Sodium bicarbonate as it increases Salicylate absorption.
2- Purgatives: Na sulphate 5 - 10 gm oral.
3- Fluids and electrolytes:
* (Glucose 10% + Saline 0.9% → 2 : 1) up to 15 mg/kg/hour.
* In shocked patient: blood or plasma transfusion.
4- Cardiac and respiratory care:
* Oxygen inhalation + 5% CO2.
* May be artificial respiration.
5- Alkalinization of urine.
6- Forced alkaline diuretics:
* Used only to reduce duration of coma when salicylate level is more than 50 mg% or to decrease
complications.
* Contraindicated in shock, heart failure, renal failure or history of respiratory failure.
* (500 ml 0.9% saline + 1000 ml glucose 5% + 20 ml NaHCO3 + 25 mEq K to each liter of IV solution +
KCl 3 gm) :
This Cocktail is given over a complete hour.
Give another similar Cocktail over the second hour.
And another similar one over the next hour.
* But in children give 30 ml/kg/hour.
* Poisoning by Aspirin is common as Aspirin is abundant in many homes.
* The patient should swallow at least more than 40 Aspirin tablets to reach intoxication level.
* CNS stimulation: Fever - sweeting - burning pain in stomach - bloody vomiting - delirium - hypercapnia.
* Followed by CNS depression: Drowsiness - coma - respiratory failure and cardiovascular failure.
Treatment:
1- Gastric lavage. 2- Purgatives. 3- Fluids and electrolytes. 4- Cardio-respiratory care. 5- Alkalinization of
urine. 6- Forced alkaline diuretics.
1- Gastric lavage (repeated):
Using activated charcoal or milk.
Do not use Sodium bicarbonate as it increases Salicylate absorption.
2- Purgatives: Na sulphate 5 - 10 gm oral.
3- Fluids and electrolytes:
* (Glucose 10% + Saline 0.9% → 2 : 1) up to 15 mg/kg/hour.
* In shocked patient: blood or plasma transfusion.
4- Cardiac and respiratory care:
* Oxygen inhalation + 5% CO2.
* May be artificial respiration.
5- Alkalinization of urine.
6- Forced alkaline diuretics:
* Used only to reduce duration of coma when salicylate level is more than 50 mg% or to decrease
complications.
* Contraindicated in shock, heart failure, renal failure or history of respiratory failure.
* (500 ml 0.9% saline + 1000 ml glucose 5% + 20 ml NaHCO3 + 25 mEq K to each liter of IV solution +
KCl 3 gm) :
This Cocktail is given over a complete hour.
Give another similar Cocktail over the second hour.
And another similar one over the next hour.
* But in children give 30 ml/kg/hour.
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