Lye

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Alternative names
Sodium hydroxide

Definition
This poisoning is from an overdose of sodium hydroxide.

Poisonous Ingredient
Sodium hydroxide

Where Found

• Many industrial solvents and cleaners (hundreds to thousands of construction agents, flooring strippers, brick cleaners, cements, and many others)
  
• Some aquarium products
  
• Some drain cleaners
  
• Some oven cleaners
  
• Clinitest
  
• Some hair straighteners
  
• Lye
  
• Some metal polishes

Note: This list may not be all inclusive.

Symptoms

• Respiratory
  o Breathing difficulty (from inhalation)
  o Throat swelling (which may also cause breathing difficulty)
  
• Eyes, ears, nose, and throat
  o Severe pain in the throat
  o Severe pain or burning in the nose, eyes, ears, lips, or tongue
  o Loss of vision
  
• Gastrointestinal
  o Severe abdominal pain
  o Vomiting
  o Burns of the esophagus (food pipe)
  o Vomiting blood
  o Blood in the stool
  
• Heart and blood vessels
  o Hypotension (low blood pressure) develops rapidly
  o Collapse
  
• Skin
  o Irritation
  o Burn
  o Necrosis (holes) in the skin or underlying tissues
  
• Blood
  o Severe change in pH (too much or too little acid in the blood, which leads to damage in all of the body organs)

Home Treatment
DO NOT INDUCE VOMITING.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the chemical was swallowed, give water or milk IMMEDIATELY. However, DO NOT give liquids if the patient is vomiting or mental status appears altered.

Before Calling Emergency
Determine the following information:

• The patient’s age, weight, and condition
  
• The name of the product (ingredients and strengths if known)
  
• The time it was swallowed
  
• The amount swallowed

Poison Control, or a local emergency number
Follow all instructions given to you by the poison control center. It is always necessary to seek medical attention for this type of exposure. Take the container with you to the emergency room. See poison control centers for the national toll-free hotline.

What to expect at the emergency room
Some or all of the following procedures may be performed:

• For swallowed poison
  o Endoscopy—the placement of a camera down the throat to see the extent of burns to the esophagus and the stomach.
  o Give IV fluids
  o Admission to the hospital
  o Give an antidote
  o Treat the symptoms
  
• For inhaled poisons
  o A breathing tube may need to be inserted
  o Oxygen
  o Admission to the hospital or to the intensive care unit
  o Bronchoscopy (inserting a camera down the throat into the airway to evaluate the extent of burns to the airway and lungs)
  
• For skin exposure
  o Irrigation (washing of the skin), perhaps every few hours for several days
  o Skin debridement (surgical removal of burned skin)
  o Admission or transfer to a hospital that specializes in burn care

Expectations (prognosis)

The prognosis (probable outcome) depends on how rapidly the alkali was diluted and neutralized. Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible.

The ultimate outcome depends on the extent of this damage. Damage continues to occur to the esophagus and stomach for several weeks after the alkali was swallowed, and death may occur as long as a month later.

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