When is inpatient care indicated for caustic ingestions?

Updated: Dec 09, 2020
  • Author: Derrick Lung, MD, MPH, FACEP, FACMT; Chief Editor: David Vearrier, MD, MPH  more...
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Admit, for observation and possible endoscopy, all small children, symptomatic patients, those with altered mental status, and those whose ingestions are worrisome for other reasons, such as large volumes, high concentrations, or unique issues such as those posed by hydrogen fluoride or phenol. Admit all symptomatic patients to the ICU to closely monitor their airway status and to watch for signs of perforation.

Ensure that all patients take nothing per mouth (NPO) until the extent of injury has been determined. Establish an intravenous line to administer fluids and medications.

Administer parenteral analgesics as needed for pain. Monitor for signs of sedation and respiratory depression.

Rollin et al have proposed an algorithm for surgical management of caustic ingestion injuries in adult patients. [7]

If an ICU bed is not available or if endoscopy is not available when indicated, transfer is advised.

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