A 19-year-old woman presents after ingesting aspirin. She is vomiting, tinnitus is present, RR 32, pH 7.49, PaCO2 2.9 kPa, bicarbonate 18 mmol/L and

Question

A 19-year-old woman presents after ingesting aspirin. She is vomiting, tinnitus is present, RR 32, pH 7.49, PaCO2 2.9 kPa, bicarbonate 18 mmol/L and salicylate level is high. She is alert and creatinine is normal. What is the most appropriate next step in management?

Accepted Answer

Start intravenous sodium bicarbonate for urinary alkalinisation and seek toxicology advice

Answer

Sedate with benzodiazepines to reduce respiratory rate

Answer

Discharge because pH is alkalotic

Answer

Give acetylcysteine as antidote

Answer

Give activated charcoal alone and stop monitoring

Salicylate poisoning with mixed acid-base disorder — SCE Acute Medicine MCQ

A 19-year-old woman presents after ingesting aspirin. She is vomiting, tinnitus is present, RR 32, pH 7.49, PaCO2 2.9 kPa, bicarbonate 18 mmol/L and salicylate level is high. She is alert and creatinine is normal. What is the most appropriate next step in management?