You and your partner are dispatched to a scene, where you find a 8 year old whose mother says he has taken a whole container of aspirin thinking it was candy. You see the aspirin bottle and pills gone. What to do you do?
A. Don't administer charcoal because it has no effect on aspirin.
B. Blindfold the patient then have him/her drink it.
C. Direct patient to close their eyes and hold their nose and chug.
D. Call medical control, administer charcoal in foam up with straw.
E. Call poison control to get directions on what to do.
A is incorrect information.
B I hope you posted this only to be remotely funny (which you did not suceed IMO)
You better NEVER EVER blindfold a patient and ask for "blind trust" which you will completely destroy and lose forever.
C This may come into play. After all we are tallking about an 8 year old. They are smart and know the deal. However no 8 year old I know would mistake ASA for candy and they certainly wouldnt make it past chewing up the first one (have you ever chewed ASA, I have)
D is a possibility depending on your area
E is another possibillity depending on your area
Mikey, you have any links to this study you mentioned? Or is it the one referred to in Wikipedia??
Anyways, here is some information courtesy of wikipedia as well. It seems spot on so I do not mind sharing, but I would like to see the study referenced unless it is the one from wikipedia as I already saw that one.
Ultimately, if enough is taken, you are most likely in for a long treatment course, typically ending up with some hemo dialysis.
I am sure Rid or Vent may have much more valid, relevant input shortly as admittedly I have not had an ASA overdose in several years.
Overdose
Aspirin overdose can be acute or chronic. In acute poisoning, a single large dose is taken; in chronic poisoning, supratherapeutic doses are taken over a period of time. Acute overdose has a mortality rate of 2%. Chronic overdose is more commonly lethal with a mortality rate of 25%; chronic overdose may be especially severe in children.[83]
[edit] Symptoms
Aspirin overdose has potentially serious consequences, sometimes leading to significant morbidity and mortality. Patients with mild intoxication frequently have nausea and vomiting, abdominal pain, lethargy, tinnitus, and dizziness. More significant symptoms occur in more severe poisonings and include hyperthermia, tachypnea, respiratory alkalosis, metabolic acidosis, hyperkalemia, hypoglycemia, hallucinations, confusion, seizure, cerebral edema, and coma. The most common cause of death following an aspirin overdose is cardiopulmonary arrest usually due to pulmonary edema.[84]
[edit] Toxicity
The acutely toxic dose of aspirin is generally considered greater than 150 mg per kg of body mass.[55] Moderate toxicity occurs at doses up to 300 mg/kg, severe toxicity occurs between 300 to 500 mg/kg, and a potentially lethal dose is greater than 500 mg/kg.[85] This is the equivalent of many dozens of the common 325 mg tablets, depending on body weight. Chronic toxicity may occur following doses of 100 mg/kg per day for two or more days.[85]
[edit] Treatment
All overdose patients should be conveyed to a hospital for assessment immediately. Initial treatment of an acute overdose includes gastric decontamination. This is achieved by administering activated charcoal, which adsorbs the aspirin in the gastrointestinal tract. Stomach pumps are no longer routinely used in the treatment of poisonings but are sometimes considered if the patient has ingested a potentially lethal amount less than 1 hour previously.[86] Inducing emesis with syrup of ipecac is not recommended.[55] Repeated doses of charcoal have been proposed to be beneficial in aspirin overdose;[87] although, one study found that repeat dose charcoal might not be of significant value.[88] However, most clinical toxicologists will administer additional charcoal if serum salicylate levels are increasing.
Patients are monitored until their peak salicylate blood level has been determined.[57] Blood levels are usually assessed four hours after ingestion and then every two hours after that to determine the maximum level. Maximum levels can be used as a guide to toxic effects expected.[89]
There is no antidote to salicylate poisoning. Monitoring of biochemical parameters such as electrolytes, liver and kidney function, urinalysis, and complete blood count is undertaken along with frequent checking of salicylate and blood sugar levels. Arterial blood gas assessments are performed to test for respiratory alkalosis and metabolic acidosis. Patients are monitored and often treated according to their individual symptoms, patients may be given intravenous potassium chloride to counteract hypokalemia, glucose to restore blood sugar levels, benzodiazepines for any seizure activity, fluids for dehydration, and importantly sodium bicarbonate to restore the blood's sensitive pH balance. Sodium bicarbonate also has the effect of increasing the pH of urine, which in turn increases the elimination of salicylate. Additionally, hemodialysis can be implemented to enhance the removal of salicylate from the blood. Hemodialysis is usually used in severely poisoned patients; for example, patients with significantly high salicylate blood levels, significant neurotoxicity (agitation, coma, convulsions), renal failure, pulmonary edema, or cardiovascular instability are hemodialyzed.[57] Hemodialysis also has the advantage of restoring electrolyte and acid-base abnormalities while removing salicylate;[57] hemodialysis is often life-saving in severely ill patients.
