What is the specific protocol for treating aspirin toxicity?

The treatment protocol for aspirin toxicity often involves alkalinizing the urine to enhance the elimination of salicylate. Administering sodium bicarbonate is a common and effective approach because it increases urine pH, promoting renal excretion of the drug. The objective is to titrate the sodium bicarbonate to achieve a urine pH of approximately 7.5, which optimally enhances salicylate clearance.

While activated charcoal is an important part of managing acute poisoning, its administration must occur within a specific time frame after ingestion, generally within an hour, to be effective. Hence, it cannot be given at any time post-ingestion without considering the timing and clinical situation. Furthermore, IV fluids alone would not address the metabolic derangements caused by aspirin toxicity, which also includes respiratory alkalosis and metabolic acidosis. Lastly, digoxin and potassium supplements are not relevant for treating aspirin toxicity and do not contribute to the management of this condition.

Thus, using sodium bicarbonate to titrate urine pH effectively helps manage aspirin toxicity, making it the correct protocol in this scenario.