USE OF A PLASMA SALICYLATE ASSAY SERVICE IN A MEDICAL UNIT IN HONG-KONG - A FOLLOW-UP-STUDY

We have previously showed that routine screening of all patients with acute poisoning for salicylates in Hong Kong Is unnecessary, We sugges ted that plasma measurements should be restricted to those suspected o f having ingested salicylates. Our results and suggestion have since b een presented and discussed in our medical unit meetings, The impact o f our suggestion on the use of our plasma salicylate assay service was determined In this follow-up study of 196 patients presenting between October 1994 and April 1995. In 24 patients (12%), ingestion of salic ylates was suspected, and of these, 3 (12.5%) had detectable plasma sa licylate concentrations (greater than or equal to 0.3 mmol/L). The inc idence in those who had taken identifiable drugs, unidentifiable drugs but nature known, and topical medicaments was 20%, 0% and 29%, respec tively. Urinary alkalinization was necessary in the only patient with moderate to severe symptoms. In 172 patients (88%), ingestion of salic ylates was not suspected; 3 (1.7%) had plasma salicylate concentration s of 0.47-2.05 mmol/L but mild symptoms only, We confirmed that routin e screening far salicylates in all patients with acute poisoning was u nnecessary Despite our suggestion, 88% of plasma salicylate measuremen ts in this follow-up study (76% in January 1992-June 1993) involved pa tients not suspected of having ingested salicylates.