Sodium hydroxide poisoning

Definition

Sodium hydroxide is a very strong chemical that is also known as lye and caustic soda. This article discusses poisoning from touching, breathing in (inhaling), or swallowing sodium hydroxide.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or a local poison control center at 1-800-222-1222.

Alternative Names

Lye poisoning; Caustic soda poisoning

Poisonous Ingredient

Sodium hydroxide

Where Found

Sodium hydroxide is found in many industrial solvents and cleaners, including flooring stripping products, brick cleaners, cements, and many others.

It may also be found in certain household products, including:

• Aquarium products
• Clinitest tablets
• Drain cleaners
• Hair straighteners
• Metal polishes
• Oven cleaners

Note: This list is not all-inclusive.

Symptoms

• Airways and lungs
  • Breathing difficulty (from inhalation)
  • Lung inflammation
  • Sneezing
  • Throat swelling (which may also cause breathing difficulty)
• Eyes, ears, nose, and throat
  • Severe pain in the throat
  • Severe pain or burning in the nose, eyes, ears, lips, or tongue
  • Vision loss
• Esophagus, intestines, and stomach
  • Blood in the stool
  • Burns of the esophagus (food pipe) and stomach
  • Diarrhea
  • Severe abdominal pain
  • Vomiting, possibly bloody
• Heart and blood
  • Collapse
  • Low blood pressure (develops rapidly)
  • Severe change in pH (too much or too little acid in the blood)
• Skin
  • Burns
  • Irritation
  • Necrosis (holes) in the skin or underlying tissues

Home Care

Seek immediate medical help. Do NOT make a person throw up unless told to do so by poison control or a health care professional.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the chemical was swallowed, immediately give the person water or milk, unless instructed otherwise by a health care provider. Do NOT give water or milk if the patient is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.

If the person breathed in the poison, immediately move him or her to fresh air.

Before Calling Emergency

Determine the following information:

• The patient's age, weight, and condition
• The name of the product (ingredients and strengths if known)
• The time it was swallowed
• The amount swallowed

Poison Control

In the United States, call 1-800-222-1222 to speak with a local poison control center. This hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to Expect at the Emergency Room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate.

Treatment depends on how the poisoning occurred. You will be given pain medicine. Other treatments may include:

• For swallowed poison, the patient may receive:
  • Endoscopy -- the placement of a camera down the throat to see the extent of burns to the esophagus and the stomach
  • Fluids through a vein
• For inhaled poison, the patient may receive:
  • Breathing tube
  • Bronchoscopy -- camera down the throat to see burns in the airways and lungs
  • Oxygen
• For skin exposure, the patient may receive:
  • Irrigation (washing of the skin) -- perhaps every few hours for several days
  • Skin debridement (surgical removal of burned skin)

Outlook (Prognosis)

How well a patient does depends on how fast the poison is diluted and neutralized. Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible.

The ultimate outcome depends on the extent of this damage. Damage continues to occur to the esophagus and stomach for several weeks after the poison was swallowed, and death may occur as long as a month later.

References

Agency for Toxic Substances and Disease Registry (ATSDR). Managing Hazardous Materials Incidents. Volume III – Medical Management Guidelines for Acute Chemical Exposures: Sodium Hydroxide. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service; 2002.

Harchelroad FP Jr, Rottinghaus DM. Chemical burns. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 200.

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