Drain opening agents

Definition 

Drain opening agents can be found in many homes. Small children may drink them if given the opportunity. Common exposures include the agent splashing into the eyes when being poured as well as eye or airway burns from fumes from the “foaming” drain openers. All inhalations, eye exposures, or ingestions of these agents are extremely dangerous.

Poisonous Ingredient 
corrosive alkalis

Where Found 

     
  • drain cleaners or openers of various brand names

Note: This list may not be all inclusive.

Symptoms 

     
  • Respiratory       o Breathing difficulty (from inhalation)       o Throat swelling (which may also cause breathing difficulty)  
  • Eyes, ears, nose, and throat       o Burns to the eyes which may result in permanent loss of vision       o Severe pain in the throat       o Severe pain or burning in the nose, eyes, ears, lips, or tongue  
  • 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 
Seek emergency medical care immediatly. DO NOT INDUCE VOMITING. If the product is on the skin or in the eyes, flush with lots of water for at least 15 minutes. If the product was swallowed, give water or milk IMMEDIATELY. If the patient is vomiting, keep giving water or milk.

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 eye exposure       o Prolonged irrigation with saline until the pH of the surface of the eye returns to normal       o Possible admission to the hospital for long-term irrigation       o Possible surgical management  
  • 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. Eye exposure can be extremely dangerous and difficult to manage, and loss of vision is common. Extensive damage to the mouth, throat, 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. Death may occur as long as a month after the alkali was swallowed.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, 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.