Salicylate Overdose - Toxicology

Question 1

If a patient is hypotensive after a salicylate OD what’s the dose of NS/RL prior to considering vasopressors?

Answer 1

10-20 mL/kg prn

Question 2

If a patient is seizing with a known/suspected salicylate overdose what is likely the cause? How should it be treated?

Answer 2

Consider cerebral edema (severe sign of toxicity), treat with seizure medical directive

Question 3

Metabolic acidosis is severe in salicylate overdoses, how should it be treated?

Answer 3

Sodium bicarbonate infusion
3 amps bicarb in D5W at 3mL/kg/hr

Question 4

If a patient in salicylate overdose is hypoglycemic what’s the treatment?

Answer 4

Dextrose 0.5 g/kg to a max dose of 25g followed by a D10W infusion at a maintenance rate (2 mL/kg/hr)

Question 5

In a patient in salicylate overdose one must be cautious with fluid resus d/t high risk of pulmonary edema, what is the urine output goal? What is the typical output goal?

Answer 5

1-2 mL/kg, typical is 0.5-1 mL/kg/hr