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Salicylate poisoning in children by dr praythiesh brucembbs

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  • 1. PEDIATRICS SEMINAR PRESENTATION BY M.S.PRAYTHIESH BRUCE FINAL MBBS,SMIMS, KULASEKARAM
  • 2. SALICYLATE POISONING
    • MOST COMMON POISONING DANGEROUS POISONING IN CHILDREN
    • OCCUR DUE TO;
    • OVERDOSE IN SICK CHILD
    • USE OF OIL OF WINTER GREEN;
    • SALICYLATE POWDER OR OINTMENT ON BROKEN SKIN
    09/12/10 copyright (your organization) 2003
  • 3. 09/12/10 copyright (your organization) 2003
  • 4. FATAL DOSE,FATAL PERIOD
    • FATAL DOSE; 200MG/KGBODY WEIGHT IS TOXIC
    • FATAL PERIOD;ACUTE INTOXICATION 1-3 HRS
    • VARIES FROM FEW MINUTES TO SEVERAL HOURS
    09/12/10 copyright (your organization) 2003
  • 5. CLINICAL FEATURES
    • MIXED ACID BASE DISTURBANCES OCCUR WITH RESPIRATORY ALKALOSIS
    • FOLLOWED BY METABOLIC ACIDOSIS
    • IT CAN AFFECT ALL SYSTEMS OF THE BODY
    09/12/10 copyright (your organization) 2003
  • 6. GENERAL FEATURES
    • GASTROINTESTINAL;NAUSEA, VOMITING, EPIGASTRIC, PAIN, HEMATEMESIS,MALENA
    • RESPIRATORY;TACHYPNEA,HYPERPNEA,INITIALLY FOLLOWED BY ACIDOTIC BREATHING
    • CNS;HEADACHE LETHARGHYVERTIGO
    • CVS;TACHYCARDIA
    • VISION AND HEARING;TINNITUS,DEAFNESS,BLURRING AND VISION
    09/12/10 copyright (your organization) 2003
  • 7.
    • RENAL;OLIGURIA,ANURIA
    • FLUID AND ELECTROLYTED DISTURBANCES;DEHYDRATIN,SWEATING VOMITING,OVERBREATHING,HYPER OR HYPONATREMIA
    • COAGULATION SYSTEM;BLEEDING TENDENCY OCCURS
    • METABOLIC DISTURBANCES;RESPIRATORY ALKALOSIS FOLLOWED BY METABOLIC ACIDOSIS
    • HYPO/HYPERGLYCEMIA,GLUCOSURIA
    09/12/10 copyright (your organization) 2003
  • 8. COMPLICATIONS OF SALICYLATE INTOXICATION
    • REYE SYNDROME
    • CEREBRAL OEDEMA
    • RESPIRATORY FAILURE
    • SEVERE CARDIOVASCULAR COLAPSE
    • GI BLEEDING
    • ACUTE RENAL FAILURE
    • ACUTE DRUG INDUCED HEPATITIS
    09/12/10 copyright (your organization) 2003
  • 9. LABORATORY INVESTIGATIONS
    • BLOOD SALICYLATE LEVEL
    • <50MG/DL
    • 50-100MG/DL
    • >100MG/DL
    • SEVERITY OF POISONING
    • MILD
    • MODERATE
    • SEVERE
    09/12/10 copyright (your organization) 2003 BLOOD LEVEL INVESTIGATIONS DONE AT 6 HOURS OR MORE AFTER SALICYLATE INTOXICATION
  • 10. LABORATORY INVESTIGATIONS
    • HYPOGLYCEMIA
    • HYPONATREMIA
    • HYPOKALEMIA
    • ACIDEMIA
    • HYPOPROTHROMBINEMIA
    • HYPERGLYCEMIA
    • HYPERNATREMIA
    • ABNORMAL LIVER FUNCTION TESTS
    • ALTERED RENAL FUNCTION TESTS
    09/12/10 copyright (your organization) 2003
  • 11. TREATMENT
    • AIRWAY STABILISATION
    • RESTORATION OF CIRCULATION
    • REMOVAL OF DRUG FROM THE BODY
    • CORRECTION OF ACIDOSIS
    • GASTRIC EMPTYING-SYRUP OF IPECAC AS AN EMETIC
    • FLUID AND ELECTROLYTE THERAPHY
    • ACIDOSIS-NAHCO3
    • SHOCK TREATED BY ALBUMIN 5%
    09/12/10 copyright (your organization) 2003
  • 12.
    • ACTIVATED CHARCOAL
    • CATHARSIS
    • GLUCOSE ADMINISTRATION
    • ALKALIZATION OF URINE
    • DIURESIS
    • HAEMODIALYSIS,HAEMOPERFUSION OR PERITONEAL DIALYSIS
    • SEIZURES PHENOBARBITONE-(5MG?KG)
    • HYPOCALCEMIC TETANY -10%SOLUTION OF
    • CALCIUM GLUCONATE
    • PROLONGED PROTHROMBIN PARENTAL VITAMIN K
    09/12/10 copyright (your organization) 2003
  • 13.
    • NALOXONE GIVEN PARENTAL –OPIOD INGESTION
    • CARDIOGENIC PULMONARY OEDEMA-DIGITALIS GIVEN
    • RESPIRATORY FAILURE- SUPPORTIVE VENTILATION GIVEN
    09/12/10 copyright (your organization) 2003
  • 14. INDICATIONS FOR HAEMODIALYSIS/HEMOPERFUSION
    • RENAL FAILURE
    • CNS MANIFESTATIONS
    • UNRESPONSIVE ACIDOSIS(PH<7.1)
    • BLLOD SALCYLATE LEVEL
    • NON CARDIOGENIC PULMONARY OEDEMA
    • PROGRESSIVE DETERIORATION OF PATIENT
    09/12/10 copyright (your organization) 2003
  • 15. THANK YOU 09/12/10 copyright (your organization) 2003