Emergency Department Diagnosis and Management of Acetaminophen or Salicylate Toxicity

Points & Pearls Excerpt

General Principles

• An acute ingestion of >150 mg/kg of acetaminophen in children or ≥7.5 g in adults (whichever is lower), or >300 mg/kg of salicylate, marks the threshold for potential severe toxicity and poison control center consultation.
• Consider co-ingestants such as opioids, anti-cholinergics, and serotonergic agents, which may alter management. Review the ingredient list of all ingested products and assess pupils, muscle tone, reflexes, and clonus.
• Obtain an electrocardiogram for all patients with suspected acetaminophen or salicylate poisoning.