Toddler : Safety promotion and injury prevention :Aspirin (Acetylsalicylic Acid [ASA])

Aspirin (Acetylsalicylic Acid [ASA])

• Clinical Manifestations
  • Acute poisoning (early symptoms)
    • Nausea
    • Hyperventilation
    • Vomiting
    • Tinnitus
    • Diaphoresis
  • Acute poisoning (later symptoms):
    • Hyperactivity
    • Fever
    • Confusion
    • Seizures
    • Renal failure
    • Respiratory failure
  • Chronic poisoning

• • • • • • • • Same as above but subtle onset and nonspecific symptoms (often mistaken for viral illness)
              • Bleeding tendencies
          • Comments
            • It may be caused by acute ingestion (severe toxicity occurs with 300 to 500 mg/kg).
            • It may be caused by chronic ingestion (i.e., more than 100 mg/kg/day for 2 or more days) and can be more serious than acute ingestion.
            • Time to peak serum salicylate level can vary with enteric aspirin or the presence of concretions (bezoars).
          • Treatment
            • Hospitalization is required for severe toxicity.
            • Activated charcoal is given as soon as possible (unless contraindicated by altered mental status). If bowel sounds are present, may be repeated every 4 hours until charcoal appears in the stool.
            • Lavage will not remove concretions of ASA.
            • Sodium bicarbonate (intravenous) is used to correct metabolic acidosis, and urinary alkalinization may be effective in enhancing elimination; hypokalemia may interfere with achieving urinary alkalinization.
            • Be aware of the risk for fluid overload and pulmonary edema.
            • Use external cooling for hyperpyrexia.
            • Administer anticonvulsants if seizures are present.
            • Provide oxygen and ventilation for respiratory depression.
            • Administer vitamin K for bleeding.
            • In severe cases, hemodialysis (not peritoneal dialysis) is used.