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Detergent poisoning

Definition

Detergents are powerful cleaning products that may contain strong acids, alkalis, or phosphates. Cationic detergents are often used as germ-killing cleansers (antiseptics) in hospitals. Anionic detergents are sometimes used to clean carpeting. Detergent poisoning occurs when someone swallows cationic or anionic detergents.

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 your local emergency number (such as 911), or 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.

Poisonous Ingredient

Poisonous ingredients include:

• Damaging (corrosive) acids, including benzalkonium chloride

• Simple soap

Where Found

Detergent is commonly found in household cleaning products such as laundry detergent and dish detergent.

Symptoms

Detergent poisoning can cause symptoms in many parts of the body.

BLOOD

• Severe change in acid level of blood (pH balance), which leads to damage in all of the body organs

EYES, EARS, NOSE, AND THROAT

• Loss of vision

• Severe pain in the throat

• Severe pain or burning in the nose, eyes, ears, lips, or tongue

GASTROINTESTINAL SYSTEM

• Blood in the stool

• Burns and possible holes in the throat and esophagus (swallowing tube)

• Severe abdominal pain

• Vomiting

• Vomiting blood

HEART AND CIRCULATION SYSTEM

• Collapse

• Low blood pressure that develops rapidly (shock)

LUNGS AND AIRWAYS

• Breathing difficulty (from breathing in the detergent)

• Throat swelling (may also cause breathing difficulty)

SKIN

• Burns

• Holes (necrosis) in the skin or tissues underneath

• Irritation

Home Care

Seek medical help right away. Do not make a person throw up unless told to do so by poison control or a health care provider.

Before Calling Emergency

Get the following information:

• Person's age, weight, and condition

• Name of the product (and ingredients and strength, if known)

• Time it was swallowed

• Amount swallowed

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:

• Blood and urine tests.

• Breathing support, including oxygen through a tube into the lungs, and a breathing machine (ventilator).

• Bronchoscopy -- camera down the throat to look for burns in the airways and lungs (if the poison was aspirated).

• Chest x-ray.

• Electrocardiogram (ECG).

• Endoscopy -- camera down the throat to look for burns in the esophagus and the stomach.

• Fluids through a vein (by IV).

• Medicine to reverse the effect of the poison and treat symptoms.

• Surgical removal of burned skin (skin debridement).

• Tube through the mouth into the stomach to aspirate (suck out) the stomach. This is done only when the person gets medical care within 30 to 45 minutes of the poisoning, and a very large amount of the substance has been swallowed.

• Washing of the skin (irrigation) -- perhaps every few hours for several days.

Outlook (Prognosis)

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

Swallowing such poisons can have severe effects on many parts of the body. Burns in the airway or gastrointestinal tract can lead to tissue death. This may result in infection, shock, and death, even several months after the substance was swallowed. Scar tissue in the affected areas can lead to long-term problems with breathing, swallowing, and digestion.

References

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

Kuschner WG, Blanc PD. Acute responses to toxic exposures. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 103.

Review Date: 11/2/2023

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.