In older children and adults, the serum salicylate level corresponds well with severity of salicylate intoxication. In younger children, the correlation is less predictable. If the amount of salicylate ingested is known, then it is possible to estimate the peak serum salicylate level.
peak salicylate in mg/dL =
= ((mg of salicylate ingested) * (100) / (70% of body weight in g))
where:
• 70% of body weight in grams corresponds to total body water.
The Done Nomogram can be used to predict the severity of outcome based serum salicylate levels measured 6 or more hours after ingestion. However, it has several limitations:
1) assumes single dose exposure; does not correlate with multiple ingestions;
2) samples drawn less than 6 hours after ingestion will not reflect peak levels and should not be used with the nomogram;
3) enteric coated tablets have different absorption rates.
reading dividing lines from Done nomogram (serum levels in mg/dL)
|
6 hr |
12 hr |
24 hr |
36 hr |
48 hr |
60 hr |
lethal-severe line |
120 |
|
|
|
|
20 |
severe-moderate line |
88 |
|
|
|
|
|
moderate-mild line |
66 |
|
|
|
|
|
mild-asymptomatic line |
42 |
|
|
|
10 |
XX |
Specialty: Toxicology, Emergency Medicine, Critical Care
ICD-10: ,