小结
定义
病史和体格检查
关键诊断因素
- 摄入≥ 150 mg/kg 或 ≥ 6.5 g 的阿司匹林或阿司匹林等效物
- 摄入冬青油
- 未知的毒素摄入或暴露
- 自残或自杀企图
- 异常行为
- 3 岁或以下的儿童以及 70 岁或以上的成人
- 恶心、呕吐、呕血和上腹部疼痛
- 发热和发汗
- 呼吸短促
- 呼吸困难、呼吸过度、库斯莫尔呼吸
- 耳鸣和/或耳聋
- 不适和/或头晕
- 运动障碍、扑翼样震颤、木僵
- 意识错乱和/或谵妄（易激惹、幻觉）
- 昏迷和/或视盘水肿
- 癫痫发作
- 啰音＋低氧饱和
其他诊断因素
- 容量不足
- 皮疹
危险因素
- 摄入≥ 150 mg/kg 或 ≥ 6.5 g 的阿司匹林或阿司匹林等效物
- 冬青油摄入
- 摄入次水杨酸铋
- 自残或自杀未遂病史
- 3 岁或以下的儿童以及 70 岁或以上的成人
诊断性检查
首要检查
- 动脉血气 (ABG)
- 血清电解质检查
- 血清水杨酸水平
- 血清尿素和肌酐
- 血清酮体
- 血糖
- 全血细胞计数（FBC）
- 血清肝功能检查
- 血清 PT、激活 PTT、INR
- 毒理学筛查
- 胸部 X 线检查
- 心电图 (ECG)
需考虑的检查
- 超声心动图
- 头部 CT 扫描
- 脑电图 (EEG)
治疗流程
无症状：不符合入院转诊标准
无症状：符合入院转诊标准
症状性
撰稿人
作者
Chris Hoyte, MD
Medical Toxicology Fellowship Program Director
Rocky Mountain Poison and Drug Safety
Denver
Associate Professor
Department of Emergency Medicine
University of Colorado School of Medicine
Aurora
CO
利益声明
CH declares that he has no competing interests.
Eric Lavonas, MD, MS
Attending Physician
Department of Emergency Medicine and Rocky Mountain Poison and Drug Safety
Denver Health
Denver
Professor
Department of Emergency Medicine
University of Colorado School of Medicine
Aurora
CO
利益声明
EL is an author of a reference cited in this topic.
鸣谢
Dr Chris Hoyte and Dr Eric Lavonas would like to gratefully acknowledge Dr Kathryn A. Koch, a previous contributor to this topic. KAK declares that she has no competing interests.
同行评议者
Colin A. Graham, MBChB, MPH, MD, FRCSEd, FRCSGlasg, FIMCRCSEd, FCCP, FCEM, FHKCEM, FHKAM
Editor
European Journal of Emergency Medicine
Professor of Emergency Medicine
Chinese University of Hong Kong
Hong Kong
People's Republic of China
利益声明
CAG is the editor of the European Journal of Emergency Medicine and receives an annual honorarium from Wolters Kluwer Health, the journal's publishers.
Gerald F. O'Malley, DO
Director
Division of Research
Department of Emergency Medicine
Albert Einstein Medical Center
Philadelphia
PA
利益声明
GFOM declares that he has no competing interests.
Paul Wax, MD
Clinical Professor of Surgery (Emergency Medicine)
University of Texas Southwestern Medical Center
Dallas
TX
利益声明
PW is an author of a reference cited in this topic.
鉴别诊断
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- 痴呆
- 肺炎
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- 水杨酸中毒：院外治疗的循证共识指南
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