Salicylate poisoning in children by dr praythiesh brucembbs

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Salicylate poisoning in children by dr praythiesh brucembbs

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

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