CORROSIVES INORGANIC NON-METAL BASES

sources - disinfectants / detergents - hair dyes/ alkaline batteries/ cement * ESOPHAGUS LIQUEFACTIVE NECROSIS (ALKALI BURN) edema airway obstruction

MINERAL ACID
sulphuric (black) car batteries HCl (green) bleach nitric (yellow) fertilizers * STOMACH - COAGULATIVE NECROSIS + ESCHAR formation eschar slough perforation - pyloric spasm emesis stricture gastric obstruction GIT Resp Metabolic Acidosis Skin Eye OP pain, dysphagia, salivation, vomiting - stridor - acute distress synd DIC

ORGANIC ACID PHENOL (carbolic acid) OXALATE(hypoCALCEMIA)

- antiseptic - dettol - local anaesthetics - disrupt CW + denature protein rapid pulm + gastric absorption - excr = kidney (conj w glucoronide) - small portion : oxidized in liver excr in lung (odor)

pathophysio

HYPOCALCAEMIA - oxalate + CA2+ Ca OXALATE CNS tetany, convulsion Heart arrhythmia, card arrest Kidney block oliguria, RF

healing C/P

scar strictures *severe burn perforation 1. mouth to stomach PAIN 2. crying + drooling + dysphagia 3. vomiting + hematemesis 4. diarrhea + mucus + blood 5. signs of shock + collapse

Local GIT Topical

N&V skin painless brown patches mm white patches contracted pupil arrhythmia dark urine, anuria albuminuria - hepatic failure - met Hb - epith ulceration - corneal opacity

erythema, blistering - conj. Hyperaemia, corneal clouding * cause of death= - shock & dehydration - gastric necrosis & perforation - pulm complication (HCl, nitric edema asphyxia) Inv 1. pH 2. endoscopy 3. CBC, glucose, electrolyte level 4. CHEST + ABD X-ray 5. Ocular slit lamp exam 1. Care for respiration 2. NO emesis, lavage or charcoal, neutralization 3. wash skin! 4. copious irrigation of eye 5. demulcent (cold milk/water) 6. Ab 7. C/S - same as alkali + Blood gases + acid base status

Remote CNS CVS Kidney Metabolic acidosis Eye

Local - Stomach = burning pain + irritation - Oral MM = whitish patches - NVD collapse - corrosion (mouth,eso,stomach) Remote
Hypocalcemia oxalate crystals

Rx

- same in alkali + therapies for metabolic acidosis + disseminated intravascular coagulation

1. Liver + Kidney Fx test 2. ECG (arrhythmia) 3. Blood gases + acid base status 4. Phenol in urine (GC/MS) 5. Endoscopy 1. A-B 2. C hypotension, arryh (lidocaine) 3. D copious water irrigation, alcohol wash - NO emesis - lavage + MG sulphate + charcoal 4. NaHCo3 met. acidosis

- tremors - hematuria - twitches - pain - convulsion - albuminuria - arrhythmia - oligo/anuria - hyperexctblty - RF *Cause of death = - cardiac arrest - RF - convulsion 1. Serum Ca level (normal:9-11mg%) 2. Detection of Ca oxalate in urine 3. Kidney Fx test 4. ECG 1. A, B 2. C 3. Ca gluconate (10cc IV) tetany 4. Decontamination - Calcium by any route 5. severe- parathyroid extraction/ hemodialysis/hemoperfusion