A blood gas should show a mixed respiratory alkalosis and metabolic acidosis, and potentially a low potassium.
The sweating and pyrexia are due to uncoupling of oxidative phosphorylation.
The effects of salicylate are dose related:
- 150mg/kg: mild
- 250mg/kg: moderate
- >500mg/kg: severe
Later features of salicylate poisoning include:
- renal failure
- hypo or hyperglycaemia
- activated charcoal if within 1 hr
- correct acidosis with 1.26% sodium bicarb
- haemodialysis if:
- conc >700mg/l
- metabolic acidosis resistant to treatment
- acute renal failure
- pulmonary oedema
- urinary alkalinization is rarely used and is contra-indicated in cerebral or pulmonary oedema
Lets move on to consider use of haemodialysis in overdoses in general...