Bleach

Definition 
This poisoning is due to an exposure to powdered or liquid bleach.

Poisonous Ingredient 

     
  • Sodium hypochlorite

Where Found    

     
  • Household bleaches  
  • Other cleaning products

Symptoms 

     
  • Respiratory       o Breathing difficulty (from inhalation)       o Throat swelling (which may also cause breathing difficulty)  
  • Eyes, ears, nose, and throat       o Severe pain in the throat       o Severe pain or burning in the nose, eyes, ears, lips, or tongue       o Loss of vision  
  • Gastrointestinal       o Severe abdominal pain       o Vomiting       o Burns of the esophagus (food pipe)       o Vomiting blood       o Blood in the stool  
  • Heart and blood vessels       o Hypotension (low blood pressure) develops rapidly       o Collapse  
  • Skin       o Irritation       o Burn       o Necrosis (holes) in the skin or underlying tissues  
  • Blood       o Severe change in pH (too much or too little acid in the blood, which leads to damage in all of the body organs)

Home Treatment

DO NOT INDUCE VOMITING. If bleach is on the skin, wash with lots of water. If bleach is swallowed, give milk or water and seek emergency medical care immediately.

Before Calling Emergency 
Determine the following information:

     
  • The patient’s age, weight, and condition  
  • The name of the product (ingredients and strengths, if known)  
  • The time it was swallowed  
  • The amount swallowed

Poison Control, or a local emergency number 
See Poison Control centers for telephone numbers and addresses. Take the container with you to the emergency room.

What to expect at the emergency room 

Some or all of the following procedures may be performed:

     
  • For swallowed poison       o Placement of a tube down the nose and into the stomach (a nasogastric tube, or an NG tube) to wash out the stomach       o Activated charcoal administration       o Endoscopy - the placement of a camera down the throat to see the extent of burns to the esophagus and the stomach.       o Give IV fluids       o Admission to the hospital       o Give an antidote       o Treat the symptoms  
  • For inhaled poisons       o A breathing tube may need to be inserted       o Oxygen       o Admission to the hospital or to the intensive care unit       o Bronchoscopy (inserting a camera down the throat into the airway to evaluate the extent of burns to the airway and lungs)  
  • For skin exposure       o Irrigation (washing of the skin), perhaps every few hours for several days       o Skin debridement (surgical removal of burned skin)       o Admission or transfer to a hospital that specializes in burn care

Expectations (prognosis) 

The prognosis (probable outcome) depends on how rapidly the alkali was diluted and neutralized. Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible.

The ultimate outcome depends on the extent of this damage. Damage continues to occur to the esophagus and stomach for several weeks after the alkali was swallowed, and death may occur as long as a month later.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.