Management overview for aspirin and other salicylate poisonings

Common salicylates available in Australia include:

• aspirin (acetyl salicylate)—most commonly formulated as 100 mg and 300 mg immediate-release tablets
• methyl salicylate—available in its pure form (oil of wintergreen; see also Essential oil poisoning) and in lower concentrations as an inhalant solution and topical preparation
• choline salicylate—available as an analgesic gel, including for teething
• salicylic acid—available in a range of topical preparations, including teething gels and skin peeling agents.

Salicylate poisoning is relatively uncommon in Australia and usually involves deliberate acute ingestion of aspirin. Excessive doses or prolonged use of teething gels containing salicylates can be harmful to infantsChan 1996.

Patients who have ingested more than 150 mg/kg of aspirin require:

• serial assessment of the patient’s acid-base status and serum salicylate concentration
• gastrointestinal decontamination with activated charcoal.

Urinary alkalinisation is indicated in more severe poisonings.