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Salicylate poisoning with severe toxicity — RCPSC EM MCQ

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HardToxicologySalicylate poisoning with severe toxicityRCPSC EM

CTAS 1: A 30-year-old presents after ingesting aspirin tablets. Vitals are T 38.8°C, HR 122, RR 34, BP 106/64. ABG shows pH 7.48, PaCO2 20, HCO3 15; salicylate level is 6.1 mmol/L and creatinine is rising. The patient is confused and vomiting. What is the most appropriate next step?

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Correct answer: E — Start urinary alkalinisation and arrange emergent haemodialysis consultation

Salicylate toxicity produces mixed respiratory alkalosis and metabolic acidosis. Altered mental status, renal dysfunction and high levels warrant alkalinisation and dialysis consultation.

Reference: Canadian Poison Centre resources; ACMT salicylate guidance