Corrosives/caustics

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Corrosives/caustics

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Corrosives/caustics

  1. 1. CORROSIVES/CAUSTICS
  2. 2. CORROSIVES They are substances that destroys the body tissues with which they come into contact . They are: ACIDS ALKALIS OTHERS
  3. 3. ACIDS  Inorganic/Mineral acids-sulphuric acid HCl,HNO3  Organic-oxalic acid,acetic acid,formic acid.
  4. 4. SULPHURIC ACID SYNONYM:oil of vitriol,oleum PROPERTIES: heavy,colourless,hygroscopic,non- fuming USES:Batteries,industries,drain/toilet bowl cleaners,vitriolage FATAL DOSE: 20-30 ml TOXICOKINETICS: No absorption
  5. 5. MECHANISM OF ACTION Acids Release hydronium ions Protoplasmic coagulation Coagulation necrosis
  6. 6. SIGNS AND SYMPTOMS  Burning sensation of GIT  Intense thirst,  Tongue-swollen,turns black/brown  Teeth-chalky white  Drooling  vomiting  Dribbling marks on face  Stomach-perforation-peritonitis  Strictures form pyloric obstruction,antral stenosis
  7. 7. DIAGNOSIS  Litmus test:blue-pink  Clothing stains+ few drops of sodium bicarbonate,produces effervescence
  8. 8. MANAGEMENT  Decontamination of skin  Respiratory distress  Demulcents  Emergency laparotomy  Corticosteroids,antibiotics
  9. 9. THE DONT’S  No oral feeds  No emetics or charcoal  No gastic lavage  Neutralisation with alkalis is dangerous
  10. 10. HYDROCHLORIC ACID  SYNONYMS:Muriatic acid,Spirit of salts  PROPERTIES:colourless,fuming,turns yellowish with air.  USES:bleaching agent,dyeing industry,metal refinery,preparation of Cl,metal/drain/ceramics cleaner.  MEDICINAL USES:achlorhydria,Hb estimation.
  11. 11.  FATAL DOSE:30-40 ml  TOXICOKINETICS:no absorption  DIAGNOSIS: 1.litmus test 2.Stomach contents/vomitus + conc ammonia White fumes of ammonium choride
  12. 12. MECHANISM OF ACTION HCl Hydronium ions Protoplasmic coagulation(tissue proteins),forms coagulum. Coagulation necrosis Tisssue damage
  13. 13. SIGNS AND SYMPTOMS  Same as sulphuric acid poisoning  It produces pronounced respiratory distress  Greyish discolouration  Less chance of perforation  It produces less severe effects since HCl is naturally present in the body
  14. 14. MANAGEMENT  Same as for sulphuric acid poisoning  Severe pain-morphine is given  Eye injury-retraction of eye lids+prolonged irrigation with normal saline or lactated ringers soln,15-30 min  Regular follow-up for strictures/stenosis,if present,dilatation or esophagogastrotomy done.
  15. 15. NITRIC ACID  SYNONYM:aqua fortis,red spirit of nitre.  PHYSICAL PROPERTIES:colourless,yellow fuming liquid,choking odour,dissolves all metals except Pt & Sb.  USES:engraving,electroplating,gold smith- aqua regia(HNO3:HCl::3:1),fetilisers  TOXICOKINETICS: absorption is negligible  FATAL DOSE:20-30 ml
  16. 16. MECHANISM OF ACTION Reacts with protein & orgaic matter to produce trinitrophenol Liberates nitogen monoxide,xanthoprotein is formed It produces yellow discolouration of skin,coagulation of tissue proteins Produces coagulation necrosis
  17. 17. SIGNS AND SYMPTOMS  Teeth-turns yellow  Respiratory tract- coughing,rhinorrhea,dyspnoea  Abdomen-distention due to gas formation,less perforation  Oliguria with cast and antibodies
  18. 18. DIAGNOSIS  Litmus test  Stomach contents+copper when heated pungent,heavy,dark brown fumes THERAPY Same as for sulphuric acid poisoning The respiratory tract should be more secured.
  19. 19. ALKALIES Examples include: Ammonia- Ammonium hydroxide-paint,oil,refrigerant Ammonium bisulphate-fertiliser Sodium hydroxide-drain/oven cleaner Sodium carbonate-household cleaning agent,detergent pot.hydroxide-drain cleaners,hearing aid
  20. 20. PROPERTIES: Ammonia:colourless,pungent,choking Alkalis:white powder,colourless solns. FATAL DOSE: Ammonia:15-20 ml,pot.carbonate:15 gm Sod/pot hydroxide:5 gm, sod.carbonate:30 gm TOXICOKINETICS: No absorption
  21. 21. Signs and symptoms  Skin- greyish,soapy,necrosed,cold,clammy  Oesophagus- dysphagia,vomiting,drooling,haematem esis  GI-corrosion produces red/brown appearance,greyish pseudomembrane forms,burning sensation,acrid,soapy and nauseous taste.
  22. 22. Mechanism of action Hydroxide ions saponify FAs of the cell membrane Protein disruption,solubilisation Liquefaction necrosis,further penetration of alkali
  23. 23. MANAGEMENT  Decontamination of skin  Respiratory system-endotracheal intubation,cricothyrotomy,tracheostomy,oxyg en inhalation.  Demulcents-milk,egg white,lemon,barley  Assess fluid and electrolyte balance  Unbearable pain/convulsion  Corticosteroids-to prevent stricture formation  Antibiotics-if perforation seen.  Proton pump inhibitors
  24. 24. REFERENCES Fundamental of forensic medicine and toxicology,2nd edition R.Basu,pg no.391-399 Textbook for medicine and toxicology,15th edition V.V.Pillay,pg no.450-463 Forensic medicine & toxicology,2nd edn R.N.Karmakar,pg no.63-65

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