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Detergents

Definition

This poisoning is from an ingestion of a cationic or anionic detergent, or a corrosive alkali.

Poisonous Ingredient

  • Simple soap
  • Corrosive alkalis

Where Found

  • Many different detergents and soaps

Symptoms

  • Respiratory
    • Breathing difficulty (from inhalation)
    • 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
    • Loss of vision
  • Gastrointestinal
    • Severe abdominal pain
    • Vomiting
    • Burns of the esophagus (food pipe)
    • Vomiting blood
    • Blood in the stool
  • Heart and blood vessels
    • Hypotension (low blood pressure) develops rapidly
    • Collapse
  • Skin
    • Irritation
    • Burn
    • Necrosis (holes) in the skin or underlying tissues
  • Blood
    • Severe change in pH (too much or too little acid in the blood, which leads to damage in all of the body organs)

Home Treatment

IMMEDIATE CARE IS NECESSARY. Give milk or water if possible. Do not induce emesis.

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, or a local emergency number

They will instruct you if it is necessary to take the patient to the hospital. See Poison Control centers for telephone numbers and addresses. Take the container with you to the emergency room.

What to expect at the emergency room

Some or all of the following procedures may be performed:

  • For swallowed poison
    • Placement of a tube down the nose and into the stomach (a nasogastric tube, or an NG tube) to wash out the stomach
    • Activated charcoal administration
    • Endoscopy -- the placement of a camera down the throat to see the extent of burns to the esophagus and the stomach
    • Give IV fluids
    • Admission to the hospital
    • Give an antidote
    • Treat the symptoms
  • For inhaled poisons
    • A breathing tube may need to be inserted
    • Oxygen
    • Admission to the hospital or to the intensive care unit
    • Bronchoscopy (inserting a camera down the throat into the airway to evaluate the extent of burns to the airway and lungs)
  • For skin exposure
    • Irrigation (washing of the skin), perhaps every few hours for several days
    • Skin debridement (surgical removal of burned skin)
    • Admission or transfer to a hospital that specializes in burn care

Expectations (prognosis)

The prognosis (probable outcome) depends on how rapidly the alkali was 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 alkali was swallowed, and death may occur as long as a month later.

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