Hydrochloric acid: Difference between revisions
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Revision as of 10:11, 3 January 2017
Background
- Strong acid, causes coagulation necrosis due to denaturation of proteins
- Most household bleaches are only 3-6% hydrochlorite solutions, but patients may have occupational exposures if working in steel picking, chemical manufacturing, oil/gas-well acidizing, and food processing
- HCl is combustion product of polyvinyl chloride (PVC), can cause chemical inhalation injury, can persist in air for up to an hour after fire extinguished
Clinical Features
- Can be systemically absorbed and → metabolic acidosis, hemolysis, AKI
- Dermal burns
- Ingestion
- All patients with serious esophageal injuries have some initial sign/symptom
- Dysphagia, odynophagia, epigastric pain, vomiting
- Laryngotracheal injury: dysphonia, stridor, respiratory distress
- Occurs via aspiration of caustic or vomitus or inhalation of acidic fumes
- inhalation injury
- PVCs and other arrythmias
- Delayed onset (2-12 hours) pulmonary edema
- Dyspnea, chest pain
- Caustic keratoconjunctivitis
- Severe eye pain, blepharospasm, reduced visual acuity
- Altered ocular pH (normal = 7.0-7.2)
- Conjunctival injection OR blanching, chemosis, hemorrhage, epithelial defects, corneal loss OR edema, perilimbal ischemia (white ring around iris)