Acid intoxication

Question 1

Severity?

Answer 1

Depends on the H⁺ concentration

Question 2

Routes of intoxication?

Answer 2

Oral

Skin

Eye

Inhalation

Question 3

Symptoms?

Answer 3

• Coagulative necrosis on the skin, mucosa
• Spasm of glottis, glottis edema
• Coagulation is the esophagus and stomach ==> severe pain ==> shock!
• Recurring emesis ==> aspiration ==> glottis spasm
• Perforation in the stomach ==> shock, peritonitis!
• Symptoms of acidosis (collapse, coma, respiratory disturbance)
• Kidney damage ==> anuria
• Formation os scabs ==> secondary bleeding + stenosis in esphagus

Question 4

Therapy?

Answer 4

• Dilution of acid in stomach (milk, egg, no neutralization!!!)
• Oral local anesthetics
• Morphine, atropin, GC
• Drop infusion of 5% NaHCO₃ or Na-lactate
• Antimicrobial therapy

NO induction of emesis nor gastric lavage!!!!!

Question 5

K⁺, Na⁺ oxalate intoxication:

Pathomechanism

Therapy

Answer 5

Therapy:

• CaCl₂ oral
• CaCl₂ or Ca²⁺ gluconate IV
• Enhanced diuresis (excessive fluid infusion) + treatment as acid intoxication