Salicylate Toxicity (Done Nomogram)

Salicylate toxicity assessment using the Done nomogram. Note: the Done nomogram has significant limitations and clinical correlation is essential.

mg/dL

Note units - some labs report mg/L or mmol/L

hours

Nomogram starts at 6 hours; earlier levels are unreliable

Nomogram is only validated for single acute non-enteric-coated ingestion

Clinical presentation is more important than nomogram position

pH

Acidemia worsens salicylate toxicity by increasing CNS penetration

years

Children are at higher risk; nomogram was developed in children

Enter values and click Calculate to see results.

References

  1. Salicylate Toxicity Workup - Medscape — Medscape (2024). https://emedicine.medscape.com/article/1009987-workup
  2. Evaluation of the validity of the Done nomogram in the management of acute salicylate intoxication — Ann Emerg Med (1989). https://pubmed.ncbi.nlm.nih.gov/2817562/
  3. Management Priorities in Salicylate Toxicity — ACMT (2022). https://www.acmt.net/wp-content/uploads/2022/06/PRS_130313_Management-Priorities-in-Salicylate-Toxicity.pdf
  4. Acute Salicylate Toxicity in Children: Diagnosis and Treatment of Overingestion — Consultant360 (2013). https://www.consultant360.com/articles/acute-salicylate-toxicity-children-diagnosis-and-treatment-overingestion