Question

Salicylate poisoning: 
Management and outcome. 
 

Hint:

For severe salicylate poisoning, the use of hemodialysis can significantly reduce mortality and prevent long-term complications.

Answer 1

Step 1: Initial Management of Salicylate Poisoning.
1. Gastric decontamination: If the ingestion is recent, activated charcoal may be administered to limit further absorption of salicylates.
2. Alkalinization of urine: Sodium bicarbonate is given to increase the pH of urine, promoting the renal excretion of salicylates.
3. Fluid resuscitation: Intravenous fluids should be administered to correct dehydration, maintain blood pressure, and support renal function.

Step 2: Advanced Management.
1. Hemodialysis: In severe poisoning or when other treatments fail, hemodialysis is used to rapidly remove salicylates from the bloodstream.
2. Bicarbonate therapy: For patients with severe metabolic acidosis, sodium bicarbonate is given intravenously to correct the acid-base imbalance.
3. Monitoring and supportive care: Continuous monitoring of vital signs, electrolytes, and acid-base status is essential for managing salicylate poisoning.

Step 3: Outcome.
The outcome of salicylate poisoning depends on the severity of the poisoning, the timing of treatment, and the presence of complications. With early intervention, the prognosis is often favorable. However, in cases of severe poisoning with delayed treatment, the risk of permanent organ damage or death increases.

Step 4: Conclusion.
Management involves early decontamination, supportive care, and sometimes hemodialysis. The outcome depends on the timeliness of treatment, with prompt intervention leading to a better prognosis.