Acetaminophen and Salicylate Toxicity

In this episode, Sam Ashoo, MD and Dr. T.R. Eckler, MD discuss the September 2026 Emergency Medicine Practice article, Emergency Department Diagnosis and Management of Acetaminophen or Salicylate Toxicity

  • 1:13 — Welcome and topic introduction
  • 3:50 — Key rules: check levels, call Poison Control
  • 5:13 — Acetaminophen pathophysiology
  • 8:16 — Salicylate pathophysiology
  • 10:51 — Coingestions
  • 11:11 — Differential diagnosis
  • 12:19 — History & pre-hospital care
  • 15:28 — Product confusion
  • 17:08 — Toxic dose thresholds
  • 18:26 — Physical exam & vital signs
  • 20:16 — Acetaminophen toxicity stages (1-4)
  • 22:35 — Salicylate exam findings
  • 23:43 — Lab workup & testing
  • 24:45 — Acetaminophen nomogram & levels
  • 30:39 — Activated charcoal — when to give it
  • 34:11 — NAC therapy — dosing & timing
  • 37:22 — Hemodialysis for acetaminophen
  • 38:40 — King’s College Criteria
  • 41:00 — Salicylate treatment
  • 44:42 — Potassium management during alkalinization
  • 47:28 — Hemodialysis for salicylate
  • 48:05 — Intubation
  • 50:00 — Pregnancy considerations
  • 51:20 — Pediatric considerations
  • 52:06 — Emerging: fomepizole as adjunct therapy
  • 52:45 — Summary & wrap-up

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