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EM Basic

Salicylate Overdose

EM Basic

EM Basic LLC

Residency, Student, Medicine, Er, Em, Intern, Health & Fitness, Medical, Education, Emergency

4.6665 Ratings

🗓️ 23 July 2014

⏱️ 26 minutes

🧾️ Download transcript

Summary

Today's episode is another installment for the EM Basic Project by Dr. Andrea Sarchi.  Salicylate overdose is a toxidrome that we have to be on the lookout for in the ED.  While some cases are obvious because the patient or EMS can tell us what they took, some cases are subtle and require vigilance to make the diagnosis.  In this episode we'll review the important history and physical points, how to order the right tests, manage the toxicity, and properly disposition the patient.

Transcript

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0:00.0

This is Steve Carroll, and you're listening to the Ambasa podcast. Today we're going to be

0:05.1

talking about a topic in toxicology, solicillate overdose. It's important to note that the main

0:10.6

ingredient in aspirin, solacillate, is present in many other over-the-counter formulations. A few

0:16.8

examples include topical medications for acne, the antideyreal medication peptobismal,

0:22.7

and oil of wintergreen, which is a common ingredient of Chinese herbal medications,

0:27.8

and ointments for musculoskeletal pain such as Ben Gay.

0:31.3

While the focus of this podcast will be on aspirin overdose, just know that the clinical

0:35.8

manifestations and management of all

0:38.1

solacillate intoxications are similar. I will be using the terms aspirin and solacillate interchangeably,

0:44.3

but just keep in mind that I'm referring to anything containing psillate. The use of aspirin

0:48.9

and children has decreased due to its association with RISE syndrome and the creation of other non-steroidal

0:55.2

and inflammatory drugs, but it's still a widely used analgesic, as well as an anti-plately

1:00.6

medication used in patients with cardiovascular and cerebrovascular disease. Therefore, aspirin overdose

1:06.9

is a situation that you must be prepared to handle. This episode was written by Dr.

1:11.7

Andrea Sarci under the supervision and direction of Dr. Michael Pasifaro, an EM attending affiliated

1:18.2

with the NYIT College of Osteopathic Medicine. As always, his podcast doesn't represent views

1:23.1

of opinions upon defense, the U.S. Army, and the Fort Hood Post Command. When you under the room,

1:27.4

a patient with aspirin poisoning may appear pale, diaphragmatic, or in respiratory distress. Their

1:33.2

vital signs may include tachypnea, hypothermia, hypotension, or tachycardia. The initial history

1:40.2

questions we ask the patient are the same as with any poisoning. We should try and find out

1:45.1

what the patient took, the dosage, the time in ingestion, and whether it was a suicide attempt.

1:51.3

We should also ask whether there was a single ingestion or repeated ones, whether any co-ingestants

...

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