Pediatric emergency medicine trisk 3106 3106
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HOUSEHOLD CLEANING PRODUCTS AND CAUSTICS
CLINICAL PEARLS
Though many household products do not lead to severe toxicity,
ingestion of acid and alkali caustics can lead to airway edema and
severe esophageal and gastric injury.
Patients that present with vomiting, drooling, pain, and/or stridor after
ingestion of a caustic agent should be further evaluated with upper GI
endoscopy.
Laundry detergent pods are now common household products that can
lead to vomiting, aspiration, caustic injury, and CNS depression after
exposure.
Household Cleaning Products
Soaps are oil-based surface-active agents (surfactants) used to clean oil-based
debris. A “detergent” is any cleansing product. However, in common use, the
word detergent has come to mean a household cleaning product that is based on
nonsoap surfactants, used mainly for laundering and dishwashing. In the past few
years, “laundry pods” or “single-use detergent sacs” have become popular
commercial products. Other cleaning products include disinfectant cleaners;
cleaners for drains, ovens, and toilet bowls; bleaches; and ammonia. These agents
are of concern because their accessibility to children makes them commonly
involved in human ingestions.
Approximately 8% of reported pediatric exploratory ingestions involve
household cleaning substances. Most of these cases involve children younger than
5 years, of whom only 1% to 2% of those ingesting noncorrosive products are
hospitalized. Most such exposures occur inside the home while the product is in
use. Transfer of household chemicals out of their original containers, often into
empty drinking glasses or soda bottles, remains a significant risk factor for
exposure.
Caustics
Current Evidence. Many agents possess corrosive potential when they are placed
in direct contact with biologic tissues. These agents, collectively referred to as
caustics or corrosives, may be acidic, alkaline, or rarely, have neutral pH (e.g.,
