Severity of poisoning cannot be assessed from plasma salicylate concentrations alone but salicylate intoxication is usually associated with plasma concentrations greater than 350 mg/L (2.5 mmol/L). Greater than 500 mg/kg body weight: likely toxicity is severe, possibly fatal. Greater than 250 mg/kg body weight: likely toxicity is moderate. Greater than 125 mg/kg body weight: likely toxicity is mild. The likelihood of toxicity can be gauged to a degree by: Young children: metabolic acidosis is common. Adults and older children over the age of 4 years: mixed respiratory alkalosis and metabolic acidosis, with normal or high arterial pH. Arterial blood gases (capillary gases or venous blood gases are alternatives in children): some degree of acid-base disturbance is present in most cases:. 
Plasma potassium should be checked every three hours and plasma potassium levels maintained at between 4.0-4.5 mmol/L.Renal function and electrolytes, FBC, coagulation studies (raised INR/PTR), urinary pH, and blood glucose.Measurements should be repeated every three hours until concentrations are falling.
A repeat sample should be taken after a further two hours because of the possibility of continuing absorption. The sample should be taken at least two hours (symptomatic patients) or four hours (asymptomatic patients) following ingestion, as it may take several hours for peak plasma concentrations to occur. Should be measured urgently for patients who are thought to have ingested more than 125 mg/kg of aspirin as well as those who have taken methyl salicylate or salicylamide. The severity of poisoning cannot be assessed from plasma salicylate concentrations alone and the clinical and biochemical features should also be considered. 
Salicylate concentration above 700 mg/L (5.1 mmol/L).Pulmonary oedema, CNS features, hyperpyrexia.However, ingestion of more than 250 mg/kg aspirin is likely to cause moderate toxicity and ingestion of more than 500 mg/kg aspirin causes severe and possibly fatal toxicity. Provides information about routine diagnosis, treatment and management of patients exposed to drugs, household products, and industrial and agricultural chemicals.Ĭhildren and adults who have ingested less than 125 mg/kg aspirin and have no symptoms do not require hospital admission. UK National Poisons Information Service - (see website for telephone number, as different for England and Wales, Scotland and Northern Ireland).The local poisons service should be contacted for advice: Salicylates are present in aspirin medications and in high concentrations of oil of wintergreen (methyl salicylate: one teaspoon = 7 g of salicylate). Salicylate poisoning is potentially fatal.
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