corrosive poisoning


corrosive poisoning

Poisoning by strong acids, alkalies, strong antiseptics including bichloride of mercury, carbolic acid (phenol), Lysol, cresol compounds, tincture of iodine, and arsenic compounds. These agents cause tissue damage similar to that caused by burns. If the substances have been swallowed, any part of the alimentary canal may be affected. Tissues involved are easily perforated. Death may result from shock or from asphyxiation caused by swelling of the throat and pharynx. Esophageal injury and stricture may be a late complication.individual poisons in

Symptoms

This type of poisoning is marked by intense burning of the mouth, throat, pharynx, and abdomen; abdominal cramping, retching, nausea, and vomiting, and often collapse. There may be hematemesis and diarrhea; the stools are watery, mucoid, bloody, and possibly stained with the poison or its products, resulting from its action on the contents of the alimentary tract. Stains of the lips, cheeks, tongue, mouth, or pharynx are often a characteristic brown; stains on the mucous membranes may be violet or black. Carbolic acid (phenol) stains are white or gray, resembling boiled meat; hydrochloric acid stains are grayish, nitric acid, yellow; sulfuric acid leaves tan or dark burns.

Treatment

Immediate treatment in a hospital is mandatory. It is important to try to discover the chemical substance ingested, and all materials such as food, bottles, jars, or containers should be saved. This is essential if the patient is comatose or an infant.

CAUTION!

In treating corrosive poisoning, vomiting must not be induced; gastric lavage must not be attempted; and no attempt should be made to neutralize the corrosive substance.

Vomiting will increase the severity of damage to the esophagus by renewing contact with the corrosive substance. Gastric lavage may cause the esophagus or stomach to perforate. If the trachea has been damaged, tracheostomy may be needed. Emergency surgery must be considered if there are signs of possible perforation of the esophagus or of the abdominal viscera. Opiates will be needed to control pain. For esophageal burns, broad-spectrum antibiotic and corticosteroid therapy should be started. Intravenous fluids will be required if esophageal or gastric damage prevents ingestion of liquids. Long-range therapy will be directed toward preventing or treating esophageal scars and strictures.

See also: poisoning

corrosive poisoning

Poisoning with strong acids or alkalis capable of causing rapid tissue destruction and shrinkage. Survivors often suffer severe narrowing (strictures) or obstruction of the gullet. Milk by mouth is the best readily available first aid treatment. Liver and kidney damage is common.