What is the focus of clinical history in suspected caustic ingestions?

Updated: Dec 09, 2020
  • Author: Derrick Lung, MD, MPH, FACEP, FACMT; Chief Editor: David Vearrier, MD, MPH  more...
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Rapidly obtaining reliable information on the particular agent involved is vital. This is particularly true of uncommon caustic agents, some of which have important toxic concerns beyond those of a simple caustic ingestion.

A good example of this is the potential for abrupt, life-threatening hypocalcemia following ingestion of hydrogen fluoride, even in a relatively dilute form such as that found in some rust removers. Case reports of patients surviving such suicidal ingestions underline the value of being able to anticipate and aggressively manage the systemic hypocalcemia, which is unique to hydrogen fluoride, with intravenous calcium. Other examples of caustic agents with unique toxicities include phenol, zinc chloride, and mercuric chloride, all of which can cause significant systemic toxicity and which may require specifically directed management.

Material Safety Data Sheets (MSDS), online databases, and consultations with the local poison center are all ways for clinicians to rapidly familiarize themselves with unfamiliar caustic agents.

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