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===[[Caustics]]=== | |||
*Substances that cause damage on contact with body surfaces | *Substances that cause damage on contact with body surfaces | ||
*Degree of injury determined by pH, concentration, volume, duration of contact | *Degree of injury determined by pH, concentration, volume, duration of contact | ||
| Line 5: | Line 6: | ||
*Corrosive agents have reducing, oxidising, denaturing or defatting potential | *Corrosive agents have reducing, oxidising, denaturing or defatting potential | ||
===Alkalis=== | ====Alkalis==== | ||
*Accepts protons → free hydroxide ion, which easily penetrates tissue → cellular destruction | *Accepts protons → free hydroxide ion, which easily penetrates tissue → cellular destruction | ||
**Liquefactive necrosis and protein disruption may allow for deep penetration into surrounding tissues | **Liquefactive necrosis and protein disruption may allow for deep penetration into surrounding tissues | ||
*Examples | *Examples | ||
**Sodium hydroxide (NaOH), potassium hydroxide (KOH), | **Sodium hydroxide (NaOH), potassium hydroxide (KOH) | ||
** | ***Lye present in drain cleaners, hair relaxers, grease remover | ||
===Acids=== | **Bleach (sodium hypochlorite) and Ammonia (NH3) | ||
*Proton donor → free hydrogen ion → cell death and eschar formation, which limits deeper involvement | ***Cleaning products such as oven cleaners, swimming pool chlorinator | ||
***Household bleach ingestion (4-6% sodium hypochlorite) rarely causes significant esophageal injury<ref>Wasserman RL, Ginsburg CM. Caustic substance injuries. J Pediatr. 1985;107(2):169-174. doi:10.1016/s0022-3476(85)80119-0</ref><ref>Harley EH, Collins MD. Liquid household bleach ingestion in children: a retrospective review. Laryngoscope. 1997;107(1):122-125. doi:10.1097/00005537-199701000-00023</ref> | |||
====Acids==== | |||
*Proton donor → free hydrogen ion → cell death via denatured protein → coagulation necrosis and eschar formation, which limits deeper involvement | |||
**However, due to pylorospasm and pooling of acid, high-grade gastric injuries are common | **However, due to pylorospasm and pooling of acid, high-grade gastric injuries are common | ||
***Mortality rate is higher compared to strong alkali ingestions | ***Mortality rate is higher compared to strong alkali ingestions | ||
*Can be systemically absorbed and → metabolic acidosis, hemolysis, AKI | *Can be systemically absorbed and → [[metabolic acidosis]], hemolysis, AKI | ||
*Examples | *Examples | ||
**Hydrochloric acid (HCl), hydrofluoric acid (HF), Sulfuric acid (H2SO4) | **Hydrochloric acid (HCl), [[hydrofluoric acid]] (HF), Sulfuric acid (H2SO4), Phosphoric acid, Oxalic Acid, Acetic acid | ||
**Found in: auto batteries, drain openers, metal cleaners, swimming pool | ***Found in: auto batteries, drain openers, toilet bowl, metal cleaners, swimming pool cleaners, rust remover, nail primer | ||
Latest revision as of 17:45, 17 February 2021
Caustics
- Substances that cause damage on contact with body surfaces
- Degree of injury determined by pH, concentration, volume, duration of contact
- Acidic agents cause coagulative necrosis
- Alkaline agents cause liquefactive necrosis (considered more damaging to most tissues)
- Corrosive agents have reducing, oxidising, denaturing or defatting potential
Alkalis
- Accepts protons → free hydroxide ion, which easily penetrates tissue → cellular destruction
- Liquefactive necrosis and protein disruption may allow for deep penetration into surrounding tissues
- Examples
- Sodium hydroxide (NaOH), potassium hydroxide (KOH)
- Lye present in drain cleaners, hair relaxers, grease remover
- Bleach (sodium hypochlorite) and Ammonia (NH3)
- Sodium hydroxide (NaOH), potassium hydroxide (KOH)
Acids
- Proton donor → free hydrogen ion → cell death via denatured protein → coagulation necrosis and eschar formation, which limits deeper involvement
- However, due to pylorospasm and pooling of acid, high-grade gastric injuries are common
- Mortality rate is higher compared to strong alkali ingestions
- However, due to pylorospasm and pooling of acid, high-grade gastric injuries are common
- Can be systemically absorbed and → metabolic acidosis, hemolysis, AKI
- Examples
- Hydrochloric acid (HCl), hydrofluoric acid (HF), Sulfuric acid (H2SO4), Phosphoric acid, Oxalic Acid, Acetic acid
- Found in: auto batteries, drain openers, toilet bowl, metal cleaners, swimming pool cleaners, rust remover, nail primer
- Hydrochloric acid (HCl), hydrofluoric acid (HF), Sulfuric acid (H2SO4), Phosphoric acid, Oxalic Acid, Acetic acid