Serum salicylates (until consistently Continuous bicarbonate in D5W to achieve and maintain urine alkalization.Consider bicarbonate loading dose, especially if arterial pH The ingested aspirin dose is known to be > 500 mg/kg.Salicylate combinations with other substances (like opioids) can lead to mixed intoxications that require specific management (e.g., naloxone).

Intubating patients with salicylate toxicity is dangerous! If intubation is required, extra care should be taken to maximize minute ventilation, as there is a high risk of worsening acidosis and death. Serum salicylates > 90 mg/dL ( > 80 mg/dL if renal function impaired) or arterial pH ≤ 7.2 despite supportive care.Serum salicylates > 100 mg/dL ( > 90 mg/dL if renal function impaired).Indications for hemodialysis in salicylate toxicity Indications for intubation in salicylate toxicity Maximize minute ventilation (e.g., at least 8–10 mL/kg/breath).Administer bicarbonate prior to intubation.Evaluate the need for intubation but avoid intubation, if possible.For symptomatic patients: Consult ICU, nephrology, and toxicology.

Assess the severity of salicylate toxicity (see salicylate toxicity severity above).

Aspirin antidote