最后审阅: 14 四月 2021
最后更新: 09 十一月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 未知的毒素摄入或暴露
  • 意识模糊、定向障碍、激越
  • 昏迷
  • 惊厥
  • 发热、出汗、四肢温热、洪脉
  • 呼吸困难
  • 呼吸急促、过度通气、Kussmaul 呼吸
  • 耳鸣和/或耳聋
  • 恶心、呕吐和上腹部疼痛
  • 不适和/或头晕
  • 啰音+低氧饱和度(心力衰竭的体征
  • 日常生活活动能力恶化、非局灶性神经系统异常

其他诊断因素

  • 血容量缺失/脱水
  • 皮疹
  • 室性心律失常和心脏停搏
  • 呕血
  • 弥散性血管内凝血

危险因素

  • 摄入 ≥125 mg/kg 水杨酸
  • 冬青油摄入
  • 摄入次水杨酸铋
  • 自残或自杀未遂病史
  • ≤3 岁儿童以及 ≥70 岁老人

诊断性检查

首要检查

  • 血浆水杨酸浓度
  • 动脉血气分析 (ABG)
  • 血清电解质、尿素和肌酐
  • 血清凝血酶原时间( PT)、活化 PTT、INR
  • 全血细胞计数 (FBC
  • 毛细血管血糖
  • 心电图(ECG

需考虑的检查

  • 其他毒理学检测
  • 胸部 X 线检查(CXR

治疗流程

撰稿人

Emergency Medicine Consultant

Royal London Hospital

Barts Health NHS Trust

Honorary senior lecturer

Queen Mary University

London

UK

利益声明

JG declares that he has no competing interests.

Education Academy Fellow in Critical Care

Newham University Hospital

London

UK

利益声明

JK declares that he has no competing interests.

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work is retained in parts of the content:

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

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

同行评议者展开全部内容

Consultant

Emergency Department

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield

UK

利益声明

AC declares that he has no competing interests.

Section Editor, BMJ Best Practice

利益声明

CP declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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