Salicylate Toxicity Clinical Presentation: History, Physical Examination (2024)

Author

Muhammad Waseem, MBBS, MS, FAAP, FACEP, FAHA Professor of Emergency Medicine and Clinical Pediatrics, Weill Cornell Medical College; Attending Physician, Departments of Emergency Medicine and Pediatrics, Lincoln Medical and Mental Health Center; Adjunct Professor of Emergency Medicine, Adjunct Professor of Pediatrics, St George's University School of Medicine, Grenada

Muhammad Waseem, MBBS, MS, FAAP, FACEP, FAHA is a member of the following medical societies: American Academy of Pediatrics, American Academy of Urgent Care Medicine, American College of Emergency Physicians, American Heart Association, American Medical Association, Association of Clinical Research Professionals, Public Responsibility in Medicine and Research, Society for Academic Emergency Medicine, Society for Simulation in Healthcare

Disclosure: Nothing to disclose.

Coauthor(s)

Muhammad Aslam, MD Professor of Pediatrics, University of California, Irvine, School of Medicine; Neonatologist, Division of Newborn Medicine, Department of Pediatrics, UC Irvine Medical Center

Muhammad Aslam, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Joel R Gernsheimer, MD, FACEP Visiting Associate Professor, Department of Emergency Medicine, Attending Physician and Director of Geriatric Emergency Medicine, State University of New York Downstate Medical Center

Joel R Gernsheimer, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Geriatrics Society

Disclosure: Nothing to disclose.

Chief Editor

Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, Wisconsin Medical Society

Disclosure: Nothing to disclose.

Acknowledgements

Fred Harchelroad, MD, FACMT, FAAEM, FACEP Chair, Department of Emergency Medicine, Director of Medical Toxicology, Allegheny General Hospital; Associate Professor, Department of Emergency Medicine, Drexel University College of Medicine

Disclosure: Nothing to disclose.

Lance W Kreplick, MD, FAAEM, MMM Medical Director of Hyperbaric Medicine, Fawcett Wound Management and Hyperbaric Medicine; Consulting Staff in Occupational Health and Rehabilitation, Company Care Occupational Health Services; President and Chief Executive Officer, QED Medical Solutions, LLC

Lance W Kreplick, MD, FAAEM, MMM, is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physician Executives

Disclosure: Nothing to disclose.

Michael E Mullins, MD Assistant Professor, Division of Emergency Medicine, Washington University in St Louis School of Medicine; Attending Physician, Emergency Department, Barnes-Jewish Hospital

Michael E Mullins, MD is a member of the following medical societies: American Academy of Clinical Toxicology and American College of Emergency Physicians

Disclosure: Johnson & Johnson stock ownership None; Savient Pharmaceuticals stock ownership None

Mark S Slabinski, MD, FACEP, FAAEM Vice President, EMP Medical Group

Mark S Slabinski, MD, FACEP, FAAEM is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Ohio State Medical Association

Disclosure: Nothing to disclose.

Asim Tarabar, MD Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Merck Salary Employment

John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Salicylate Toxicity Clinical Presentation: History, Physical Examination (2024)

FAQs

Salicylate Toxicity Clinical Presentation: History, Physical Examination? ›

Symptoms and Signs of Salicylate Poisoning

What are the findings of salicylate toxicity? ›

Nausea, vomiting, diaphoresis, and tinnitus are the earliest signs and symptoms of salicylate toxicity. Other early symptoms and signs are vertigo, hyperventilation, tachycardia, and hyperactivity. As toxicity progresses, agitation, delirium, hallucinations, convulsions, lethargy, and stupor may occur.

Which are common clinical manifestations of salicylate poisoning select all that apply? ›

GI symptoms, signs, and manifestations of salicylate poisoning include the following:
  • Nausea and vomiting, which are very common with acute toxicity.
  • Epigastric pain.
  • GI hemorrhage - More common with chronic intoxication.
  • Intestinal perforation.
  • Pancreatitis.
  • Hepatitis - Generally in chronic toxicity; rare in acute toxicity.
May 28, 2024

What are the identifying findings of aspirin toxicity? ›

The earliest symptoms of acute aspirin poisoning may include ringing in the ears (tinnitus) and impaired hearing. More clinically significant signs and symptoms may include rapid breathing (hyperventilation), vomiting, dehydration, fever, double vision, and feeling faint.

What is the triad of salicylate toxicity? ›

The classic triad of mild toxicity is nausea, vomiting and tinnitus, in fact physicians would commonly dose salicylates until the patient complained of tinnitus. These patients now present more commonly in the exams than the emergency department.

What are the symptoms of salicylate overload? ›

In an acute salicylate overdose, the onset of symptoms will occur within 3 to 8 hours. The severity of symptoms is dependent on the amount ingested. For mild ingestions (salicylate levels 40 to 80 mg/dL) nausea, vomiting, and generalized abdominal pain are common. Tachypnea is usually present.

What is the characteristic symptom for acute salicylate poisoning? ›

Acute intoxication presents with classical symptoms of vomiting, tinnitus, hyperventilation, respiratory alkalosis and metabolic acidosis. Salicylate is found in a number of oral and topical preparations including: Medications - Aspirin and aspirin containing drug compounds.

What is the first symptom that a resident with salicylate toxicity will experience Quizlet? ›

Early symptoms include nausea, vomiting, diaphoresis, and tinnitus. Normal adult patients will have increasing metabolic acidosis with significant respiratory compensation and alkalotic serum pH.

What are the most common symptoms of chronic salicylate intoxication in adults? ›

With chronic overdose, symptoms and signs tend to be nonspecific, vary greatly, and may suggest sepsis. They include subtle confusion, changes in mental status, fever, hypoxia, noncardiogenic pulmonary edema, dehydration, lactic acidosis, and hypotension.

What are the characteristics of salicylates? ›

Salicylic acid is a crystalline organic carboxylic acid and has keratolytic, bacteriostatic and fungicidal properties. It is poisonous to our body when consumed in large. It can be in use as an antiseptic and as a food preservative when consumed in small quantities.

Which symptoms of aspirin toxicity should be checked by nurse first? ›

With acute overdose, early symptoms include nausea, vomiting, tinnitus, and hyperventilation. Later symptoms include hyperactivity, fever, confusion, and seizures.

What should I monitor after taking aspirin? ›

Check with your doctor right away if you have black, tarry stools, severe or continuing stomach pain, unusual bleeding, bruising, or weakness, or vomiting of blood or material that looks like coffee grounds.

How do you monitor aspirin toxicity? ›

A blood sample is taken to measure the precise level of aspirin in the blood. Measurement of the blood pH (amount of acid in the blood) and the level of carbon dioxide or bicarbonate in the blood also can help doctors determine the severity of poisoning.

What are the lab findings for salicylate toxicity? ›

Levels between 15-30 mg/dL are considered to be within the therapeutic range. Signs and symptoms of toxicity begin to appear at levels higher than 30 mg/dL. A 6-hour salicylate level higher than 100 mg/dL is considered potentially lethal and is an indication for hemodialysis.

What is chronic salicylate intoxication? ›

Chronic overdosage with salicylates can produce a syndrome of chronic salicylate intoxication. The main features of this syndrome are confused, sometimes bizarre, behavior and hyperventilation.

Which should the nurse monitor a client for that is receiving a salicylate? ›

Final answer: A nurse should monitor a client receiving salicylates for neurotoxicity, ototoxicity, nephrotoxicity, and cardiotoxicity. While salicylates can cause pulmonary problems, they're not primarily known for causing pulmonary toxicity.

What are the results of a salicylate test? ›

Patients are often symptomatic at salicylate concentrations higher than 40-50 mg/dL. Patients with salicylate concentrations approaching or exceeding 100 mg/dL usually have serious or life-threatening toxicity. Patients with chronic poisoning who have levels of 60 mg/dL or greater often have serious toxicity.

Which of the following are adverse reactions to salicylates? ›

Salicylate Allergy Symptoms
  • Asthma-like symptoms, such as wheezing and trouble breathing.
  • Headaches.
  • Nasal congestion.
  • Changes in skin color.
  • Itching, skin rash, or hives.
  • Swelling of the hands, feet, and face.
  • Stomach pain or upset.
  • Eczema.
Mar 12, 2023

What are the three major pharmacological effects produced by the salicylates? ›

Salicylates have several beneficial physiological effects. They are known to inhibit prostaglandin synthesis, reduce inflammatory activity, and aid in fever reduction and pain management.

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