Aspirin & Salicylate Overdose

Key points

• Salicylate overdose: mixed picture — respiratory alkalosis (direct medullary stimulation) + metabolic acidosis.
• Features: tinnitus, sweating, vomiting, hyperventilation, tachycardia.
• Management: urinary alkalinisation with IV sodium bicarbonate (enhances salicylate excretion).
• Severe poisoning (high levels, acidosis, CNS/renal features) → haemodialysis.
• Aspirin is normally safe to continue for dental procedures — do not confuse therapeutic use with toxicity.

Decision points in this pathway

• Severe (high level, acidosis, CNS/renal features)?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.