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Drain cleaner poisoning

Drain cleaners contain very dangerous chemicals that can be harmful to your health if you swallow them, breathe them in (inhale), or if they come in contact with your skin and eyes.

This article discusses poisoning from swallowing or breathing in drain cleaner.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

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Poisonous Ingredient

Sodium hydroxide

Where Found

This poison is found in:

• Some drain cleaners
• Some aquarium products

Note: This list may not be all-inclusive.

Symptoms

Symptoms of drain cleaner poisoning include:

• Abdominal pain (severe)
• Breathing difficulty due to throat swelling
• Burns of the mouth and throat
• Chest pain
• Collapse
• Diarrhea
• Drooling
• Loss of vision if the poison touched the eyes
• Mouth pain (severe)
• Rapid drop in blood pressure (shock)
• Throat pain (severe)
• Severe burns and tissue damage
• Vomiting, often bloody

Symptoms from getting sodium hydroxide on the skin or in the eyes include:

• Burning
• Severe pain
• Vision loss 

Home Care

Seek immediate medical help. DO NOT make a person throw up unless told to do so by Poison Control or a health care professional.

If the chemical was swallowed, immediately give the person water or milk, unless instructed otherwise by a health care provider. DO NOT give water or milk if the person is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.

If the chemical is on the skin or in the eyes, flush with at least 2 quarts (1.8 liters) for at least 15 minutes.

DO NOT give vinegar or lemon juice, as this may cause more severe burning.

Before Calling Emergency

The following information is helpful for emergency assistance:

• The person's age, weight, and condition
• The name of the product (ingredients and strength, if known)
• The time it was swallowed
• The amount swallowed

However, DO NOT delay calling for help if this information is not immediately available.

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:

• Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
• Blood and urine tests
• Camera down the throat (endoscopy) to see burns in the food pipe (esophagus) and stomach
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Fluids through a vein (intravenous or IV)
• Medicines to treat symptoms

Activated charcoal, which is used to treat other types of poisoning, does not effectively treat sodium hydroxide poisoning.

For skin exposure, treatment may include:

• Surgical removal of burned skin (debridement)
• Transfer to a hospital that specializes in burn care
• Washing of the skin (irrigation), possibly every few hours for several days

Outlook (Prognosis)

How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery.

Swallowing this type of poison can have severe effects on many parts of the body. Damage to the esophagus and stomach continues to occur for several weeks after the sodium hydroxide was swallowed. Death may occur up to several months later from additional complications. Holes (perforations) in the esophagus and stomach may cause serious infections in the inside spaces of the chest and abdomen, which may lead to death. Surgery may be needed if the chemical has perforated the esophagus, stomach, or intestine.

References

Hoyte C. Caustics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 143.

Theobald JL, Kostic MA. Poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 77.

Thomas SHL. Poisoning. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 10.

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Review Date: 1/2/2023  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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