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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