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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