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EM@3AM: Salicylate Overdose

A 22-year-old female presents to the ED after taking an entire bottle of unknown medication approximately an hour and a half ago. She describes a ringing sensation in her ears and mild nausea with no vomiting. Triage vital signs (VS): BP 122/75, HR 115, T 99.8 Oral, RR 32, SpO2 99% on RA. She is tachypneic with no increased work of breathing. What is the most likely medication overdose? What’s the next step in your evaluation and treatment? What lab tests would you like to order?

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