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Investigations

Authoring team

  • full blood count
  • prothrombin time - may be increased
  • urea and electrolytes - possible hypokalaemia
  • blood glucose - possible hypoglycaemia
  • blood gases - initially, respiratory alkalosis, followed by metabolic acidosis - except in children
  • plasma salicylate level - take sample at 6 hours or earlier if indicated; repeat at 4 hourly intervals to ensure that level is not rising due to slow absorption. Interpretation: plasma level ( mg per litre)
    • therapeutic range 150-250
    • mild 250-500
    • moderate 500-750
    • severe poisoning > 750
    • ranges for children approximately 0.6 of adult value
  • chest X-ray - pulmonary oedema, ARDS

Notes:

  • the presence of a metabolic acidosis is ominous even if the salicylate levels are not markedly elevated
  • salicylate levels are less reliable if aspirin is being taken therapeutically

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