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1. CORROSIVE POISONING
By : Dr. FAIZA MEMON

2. DEFINITION
• A Corrosive poison fixes, destroy and erodes
the surface with which it comes in contact

3. INTRODUCTION
• Corrosives are defined as solids or liquids that, by
chemical action will cause severe damage when in
contact with living tissue or they can destroy other goods.
• The corrosives are the second most commonly used
group of hazardous materials and the only group that is
more commonly encountered is the flammable liquids.
EXAMPLE: Sulfuric Acid.
• They are used in every thing from flashlight and car
batteries, to toilet bowl cleaners; from disinfectants, to
rust- proofing agents.

4. CLASSIFICATION
ACIDS ALKALIES
MINERAL ACIDS ORGANIC ACIDS
Sulfuric acid Oxalic acid Ammonia
Nitric acid Carbolic acid Caustic potash & Soda
Hydrochloric acid Picric acid Ammonium carbonate
& hydroxide
Salicylic acid Potassium & Sodium
carbonate
Acetic acid Potassium
Permanganate

5. MECHANISM OF ACTION
They cause
1. Because of its affinity with water it destroys the tissues
by rapid dehydration, this is accompanied by a
considerable generation of heat and tissues are
severally scalded.
2. Coagulates the tissue proteins with protein dissolution,
collagen destruction & cell membrane emulsification.
3. Convert Hb to Haematin by action of acid on
hemoglobin (dark color is due to acid haematin).

6. GENERAL SYMPTOMS AND SIGNS OF
CORROSIVE POISONING
• Onset of symptoms is immediate.
• Burning pain and sensation in mouth, throat, esophagus
and stomach & thus abdominal pain.
• Intense thirst
• Pain and difficulty in swallowing
– Vomiting (blood stained).
– Scanty urine and is acidic.
– Constipation with acids and diarrhea with alkalis.
– Lips and chin corroded.
– Neurogenic shock due to pain
• Skin is cold and clammy and pupils are dilated.

7. SITES LIKELY TO BE EFFECTED BY CORROSIVES
1. Skin – Face
- Dermal: Staining of skin with burning pain.
- Ocular: conjunctivitis, corneal destruction.
lacrimation, photophobia and pain.
2. Mouth & throat
3. Upper alimentary tract
4. Respiratory tract
- inhalation: Bronchial irritation, pulmonary edema,
frothy sputum, moist rales, hypotension, hemoptysis &
dyspnea.

8. EFFECTS OF CORROSIVES
EARLY EFFECTS:
1. Pain and shock.
2. Vomiting.
3. Dyspnea due to respiratory obstruction from laryngeal
edema.
LATE EFFECTS:
4. Perforation of stomach.
5. Pulmonary edema.
6. Bronchopneumonia.

9. DELAYED EFFECTS:
1. Esophageal or pyloric stricture.
2. Laryngeal stricture.
3. Pulmonary fibrosis.

10. Fatal Dose:
10-15ml (30ml).
Fatal Period:
12 to 24 hours.
Cause of death:
- instantaneous => shock
- early => suffocation within 24hrs of perforation .
- after few days => gastric inflammation
- delayed => exhaustion, stricture of esophagus &
secondary pneumonia.

11. MANAGEMENT OF CORROSIVE
POISONING
• Essentials:
– Determine relative strength of the product
(concentrated or dilute)
– Do not attempt neutralization, induced emesis, gastric
lavage or activated charcoal are all contraindicated.
– give plenty of water to the patient.
– bicarbonates are contraindicated as they yield CO2
which will result in perforation.

12. MANAGEMENT OF CORROSIVE
POISONING
- The oropharynx must be carefully examined but
normal findings do not exclude significant injury.
- Upper gastrointestinal endoscopy is the best guide
for prognosis and subsequent management.
- Signs and symptoms do not always correlate with
the severity of injury.

13. GENERAL TREATMENT OF CORROSIVE
POISONING
1) In cases of acids, it should be immediately
diluted & neutralized by administration of water.
2) Give demulcents, drinks such as barley water,
olive oil and melted butter.
3) Give corticosteroids by mouth, or injection to
prevent shock and esophageal stricture.

14. 4) Give analgesics like morphine or pethidine
for pain.
5) Dextrose saline drips I/V for dehydration
and thirst to correct electrolyte imbalance.
6) Oxygen and artificial respiration may be
needed.
7) Tracheotomy may be done if there is
suffocation due to acute edema of the glottis.

22. ALKALIS
• Like acids alkalis act as corrosive poisons when administered in a
concentrated form but act as irritant poison when dilute.
• SIGNS & SYMPTOMS:
1) The taste is nauseous & soapy.
2) Purging is a frequent symptom accompanied with severe
pain & straining. The motions consist of stringy mucous
mixed with blood.
TREATMENT:
Neutralize by weak acids chiefly vegetables, acetic acid(vinegar), citric
acid(lemon juice) mixed with large quantity of water. Morphine for pain.

23. POSTMORTEM APPEARANCES
• Signs of corrosions.
• Externally, the lips may be burnt and trickles
mark may be found running from the mouth
to the chin, neck, and chest.
• Internally, localized patches to extensive areas,
particularly in stomach.
• Perforation in the stomach is common in
sulphuric acid.

24. MEDICOLEGAL ASPECTS
Attempted Suicide with corrosives is not seen now
owing largely due to the use of other less painful
substance like barbiturates and synthetic narcotics
and organophosphate compounds.
Corrosives are rarely used for homicide owing to
their painful action.
Corrosives usually thrown on the face out of jealousy
or in fits of rage, called vitrolage. They cause severe
injury even death from accidental spilling.

25. VITROLAGE

26. Acid throwing, also called an acid attack or
vitrolage
• A form of violent, criminal assault, defined as the
premeditated act of throwing acid.
• Sulfuric acid (oil of vitriol), hydrochloric acid, nitric acid,
hydrofluoric acid or other similar, dangerous, corrosives
chemical substances, onto the body of another human being.
• With the intention to disfigure or kill.
• Perpetrators of these attacks throw acid at their victims,
usually at their faces.
-burning them, melting and damaging skin tissues
-Often exposing and sometimes dissolving even the bones

28. Treatment
• Immediate washing with water and soap
• Wash with a dilute solution of sodium or potassium
bicarbonate.
• Apply thick paste or magnesium oxide or carbonate
• Apply antibiotic- superficial & oral – reduce chance of
infection.
• Skin grafting may be needed
• Eyes- wash with water- 1% solution of sodium
bicarbonate
• Use olive oil drops.
• Eye drops containing antibiotics.