Salicylate Poisoning
Our textbook mentioned that Salicylic acid and its derivatives like aspirin are being used clinically in children for fever, for pain and as antirheumatic medication. However, there are cases of poisoning being reported because of their candy taste, a reason the children may overtake them.
Salicylic acid intoxication is synonymous with salicylism. In toxic doses, salicylamide is not metabolized to salicylic acid thus there will be pronounced central nervous system depression than what is seen in salicylism. The toxic effects are manifested when 10 grams or more of any salicylate are ingested in single or divided doses within 12-24 hours or when the blood plasma level exceeds 30 mg/dl. In children below 3 years old, toxicity maybe evident even at lower blood salicylate levels.
Clinically, salicylate poisoning may manifest as:
mild burning sensation over the throat and stomach, vomiting, anorexia, lethargy, headache, dizziness, tinnitus, difficulty of hearing, dimness of vision.
Then some will have a lucid interval of several hours followed by : confusion, disorientation, delirium, mania, hallucinations, general convulsions, coma, death
Others may also show: petechiae on the skin, melena, hematemesis, allergic reactions which are equally serious consequences of aspirin intoxication
When you see that the poisoning is happening, Immediately do the following:
1. Offer milk and activated charcoal to delay gastric emptying and absorption.
2. Give syrup of ipecac as an emetic
3. Bring immediately to the emergency room.