Plasma salicylate concentrations following overdose; are they worth it ?
Treatment following salicylate ingestion is determined by clinical evidence of toxicity. Previous studies have shown that routine measurement of plasma salicylate concentrations in all overdose patients is unnecessary except in those with clinical features suggestive of salicylate poisoning or in those who are unable to give an accurate history . This retrospective study evaluates whether plasma salicylate concentrations are appropriately measured. A retrospective study of all plasma salicylate concentrations measured in St Thomas’ Hospital Accident and Emergency department from 1 February 2001 to 31 January 2002 was conducted. Admission record cards were surveyed for history of salicylate ingestion, clinical features suggestive of a toxic salicylate concentration requiring treatment and the diagnosis recorded. Details of the salicylate overdose, concentrations and treatments were recorded. Of the 737 patients who had plasma salicylate concentrations measured, notes were available for review for 612 (82.7%) of patients. Sixteen records were excluded as salicylate concentrations had been measured inappropriately. 52.3% of patients were male. Fifty (6.8%) patients had a detectable salicylate concentration; three of these patients did not have notes available for review.