<b>Stabilise vital signs</b><br>ffOxygen and IV fluids as necessary ffGastric lavage: worthwhile up to 4 hours after poisoning as stomach emptying is delayed -ffActivated charcoal 50 g repeated as needed every 4 hours or 25 g repeated prn every 2 hours –– It delays absorption of any remaining salicylate ffTreat/prevent hypoglycaemia with Dextrose 50% 50-100 ml (Dextrose 10% 2-5 ml/kg in children) ffTepid sponging for hyperpyrexia ffTreat convulsions with IV diazepam 10 mg prn}<b>Refer to higher level of care if coma, pulmonary oedema, renal insufficiency, clinical deterioration in spite of above measures</b><br>ffTreat acidosis and enhance renal excretion in symptomatic patients with Sodium bicarbonate –– Bolus 1-2 mEq/kg (max 100 mEq) in 3-5 minutes –– Followed by an infusion of 50-75 mEq in 500 ml of Dextrose 5 %; run at 250 ml/hour in adults (run at 1.5-2 times maintenance in children) –– Mantain urine pH 7.5-8}