Alkalis poisoning

  • See also Poisoning - Acute Guidelines for initial management

    Alkalis include:
    • Drain cleaners, Oven cleaners
    • Automatic dish washing liquids & powders
    • Laundry detergents, Ammonia
    • Portland cement
    • pH of >11.5 is likely to cause significant GI ulceration
    • Attempt to obtain container to check contents and strength of substance.
    • Corrosive potential varies with concentration of specific ingredients and preparations, ie liquid preparations are more likely to cause oesophageal burns than powders.
    • Check preparations with Poisons Information Centre to determine whether ingested substance is weak, strong, irritant or corrosive in nature.

    Assessment

    Toxicity
    Exposure may lead to severe burns of GIT, especially oesophagus
    Absence of mouth or pharyngeal ulcers does not preclude gastro-oesophageal lesions

    Symptoms:
    • May be minimal
    • Pain
    • Nausea & vomiting, drooling or refusing to eat and drink
    • Stridor, respiratory distress

    Management

    • Activated charcoal is contraindicated
    • If asymptomatic treat with fluid dilution: 10ml/kg of water (max 250ml)
    • If asymptomatic after 4 hours and able to eat and drink the patient can be safely discharged
    • If any symptoms, contact surgical registrar, & admit for oesophagoscopy.