Hydrochloric acid - Revision history

Rossdonaldson1: /* Background */

2024-10-02T19:57:30Z

Background

← Revisión anterior		Revisión del 19:57 2 oct 2024
Línea 1:		Línea 1:
	==Background==		==Background==
	[[File:Hydrochloric acid 30 percent.jpg\|thumb\|Hydrochloric acid]]		[[File:Hydrochloric acid 30 percent.jpg\|thumb\|Hydrochloric acid]]
			[[File:Hydrochloric acid dissociated.svg\|thumb\|Hydrochloric acid]]
	*Strong acid, causes coagulation necrosis due to denaturation of proteins		*Strong acid, causes coagulation necrosis due to denaturation of proteins
	*Patients may have occupational exposures if working in steel picking, chemical manufacturing, oil/gas-well acidizing, and food processing		*Patients may have occupational exposures if working in steel picking, chemical manufacturing, oil/gas-well acidizing, and food processing

Rossdonaldson1: /* Background */

2024-10-02T19:55:40Z

Background

← Revisión anterior		Revisión del 19:55 2 oct 2024
Línea 1:		Línea 1:
	==Background==		==Background==
			[[File:Hydrochloric acid 30 percent.jpg\|thumb\|Hydrochloric acid]]
	*Strong acid, causes coagulation necrosis due to denaturation of proteins		*Strong acid, causes coagulation necrosis due to denaturation of proteins
	*Patients may have occupational exposures if working in steel picking, chemical manufacturing, oil/gas-well acidizing, and food processing		*Patients may have occupational exposures if working in steel picking, chemical manufacturing, oil/gas-well acidizing, and food processing

Mboyle: Remove reference to sodium hypochlorite, which is a strong base and is not the same as hydrochloric acid

2024-09-12T03:12:54Z

Remove reference to sodium hypochlorite, which is a strong base and is not the same as hydrochloric acid

← Revisión anterior		Revisión del 03:12 12 sep 2024
Línea 1:		Línea 1:
	==Background==		==Background==
	*Strong acid, causes coagulation necrosis due to denaturation of proteins		*Strong acid, causes coagulation necrosis due to denaturation of proteins
	*~~Most household bleaches are only 3-6% hydrochlorite solutions, but patients~~ may have occupational exposures if working in steel picking, chemical manufacturing, oil/gas-well acidizing, and food processing		*Patients may have occupational exposures if working in steel picking, chemical manufacturing, oil/gas-well acidizing, and food processing
	*HCl is combustion product of polyvinyl chloride (PVC), can cause chemical [[Smoke inhalation injury\|inhalation injury]], can persist in air for up to an hour after fire extinguished		*HCl is combustion product of polyvinyl chloride (PVC), can cause chemical [[Smoke inhalation injury\|inhalation injury]], can persist in air for up to an hour after fire extinguished

ClaireLewis at 20:50, 1 October 2019

2019-10-01T20:50:24Z

← Revisión anterior		Revisión del 20:50 1 oct 2019
Línea 9:		Línea 9:
	*Ingestion		*Ingestion
	**All patients with serious esophageal injuries have ''some'' initial sign/symptom		**All patients with serious esophageal injuries have ''some'' initial sign/symptom
	**Dysphagia, odynophagia, [[epigastric pain]], [[vomiting]]		**[[Dysphagia]], odynophagia, [[epigastric pain]], [[vomiting]]
	**Laryngotracheal injury: dysphonia, [[stridor]], respiratory distress		**Laryngotracheal injury: [[dysphonia]], [[stridor]], [[respiratory distress]]
	***Occurs via aspiration of caustic or vomitus or inhalation of acidic fumes		***Occurs via aspiration of caustic or vomitus or inhalation of acidic fumes
	*[[Smoke inhalation injury\|inhalation injury]]		*[[Smoke inhalation injury\|inhalation injury]]
Línea 17:		Línea 17:
	**[[Dyspnea]], [[chest pain]]		**[[Dyspnea]], [[chest pain]]
	*[[Caustic keratoconjunctivitis]]		*[[Caustic keratoconjunctivitis]]
	**Severe [[eye pain]], blepharospasm, reduced visual acuity		**Severe [[eye pain]], blepharospasm, [[vision loss\|reduced visual acuity]]
	**Altered ocular pH (normal = 7.0-7.2)		**Altered ocular pH (normal = 7.0-7.2)
	**Conjunctival injection '''OR''' blanching, chemosis, hemorrhage, epithelial defects, corneal loss '''OR''' edema, perilimbal ischemia (white ring around iris)		**Conjunctival injection '''OR''' blanching, chemosis, hemorrhage, epithelial defects, corneal loss '''OR''' edema, perilimbal ischemia (white ring around iris)
Línea 28:		Línea 28:
	===Work-up===		===Work-up===
	*Only necessary in patients with significant injury or volume of ingestion		*Only necessary in patients with significant injury or volume of ingestion
	*CBC, metabolic panel, lactate, serum calcium (if concern for [[hydrofluoric acid]] exposure		*CBC, metabolic panel, [[lactate]], serum calcium (if concern for [[hydrofluoric acid]] exposure
	*[[ECG]]		*[[ECG]]
	*Tylenol/ASA levels if concerned about coingestion (suicidal patients)		*Tylenol/ASA levels if concerned about coingestion (suicidal patients)
Línea 79:		Línea 79:

	[[Category:Misc/General]]		[[Category:Misc/General]]
			[[Category:Toxicology]]
			[[Category:Trauma]]

Rossdonaldson1: /* Ocular exposure */

2018-02-24T19:45:48Z

Ocular exposure

@@ Línea 65: / Línea 65: @@
 **Neutralization (e.g. with milk or mag citrate): generates excess heat
-===[[Caustic keratoconjunctivitis|Ocular exposure]]===
+{{Caustic ocular exposure managment}}
 ==Disposition==

ClaireLewis: /* Ocular exposure */

2017-04-03T15:31:59Z

Ocular exposure

← Revisión anterior		Revisión del 15:31 3 abr 2017
Línea 75:		Línea 75:
	*Anesthesia		*Anesthesia
	**Topical anesthetic (e.g. [[tetracaine]]) to help with discomfort.		**Topical anesthetic (e.g. [[tetracaine]]) to help with discomfort.
	**Other options include cycloplegics (e.g. atropine, cyclopentolate), IV/IM/PO analgesics		**Other options include cycloplegics (e.g. [[atropine]], [[cyclopentolate]]), IV/IM/PO analgesics
	*[[Antibiotics]]		*[[Antibiotics]]
	**Erythromycin ophthalmic ointment QID for minor burns		**[[Erythromycin]] ophthalmic ointment QID for minor burns
	**Topical fluoroquinolone for more severe burns		**Topical [[fluoroquinolone]] for more severe burns
	*Control inflammation		*Control inflammation
	**Topical steroids - prednisolone 1% ophthalmic QID for 1 week<ref>Dohlman, C.H., F. Cade, and R. Pfister, Chemical burns to the eye: paradigm shifts in treatment. Cornea, 2011. 30(6): p. 613-4.</ref>		**[[Topical steroids]] - [[prednisolone]] 1% ophthalmic QID for 1 week<ref>Dohlman, C.H., F. Cade, and R. Pfister, Chemical burns to the eye: paradigm shifts in treatment. Cornea, 2011. 30(6): p. 613-4.</ref>
	**Limit topical steroid use to 10 days to avoid corneal breakdown.<ref>Donshik, P.C., et al., Effect of topical corticosteroids on ulceration in alkali-burned corneas. Archives of ophthalmology, 1978. 96(11): p. 2117-20.</ref>		**Limit topical steroid use to 10 days to avoid corneal breakdown.<ref>Donshik, P.C., et al., Effect of topical corticosteroids on ulceration in alkali-burned corneas. Archives of ophthalmology, 1978. 96(11): p. 2117-20.</ref>
	*Ophtho consultation for all but minor burns (Severe exposures may require debridement or other surgical intervention)		*Ophtho consultation for all but minor burns (Severe exposures may require debridement or other surgical intervention)

ClaireLewis: /* See Also */

2017-01-15T22:06:10Z

ClaireLewis: /* Ingestion */

2017-01-15T22:05:54Z

Ingestion

← Revisión anterior		Revisión del 22:05 15 ene 2017
Línea 58:		Línea 58:
	**Grade IIb or higher esophageal burns: [[Methylprednisolone]] (1 g/1.73 m2 per day for 3 days), [[ranitidine]], [[ceftriaxone]], total parenteral nutrition		**Grade IIb or higher esophageal burns: [[Methylprednisolone]] (1 g/1.73 m2 per day for 3 days), [[ranitidine]], [[ceftriaxone]], total parenteral nutrition
	*Surgical intervention: indicated if perforation or peritoneal signs		*Surgical intervention: indicated if perforation or peritoneal signs
	*Contraindicated (or controversial):		*''Contraindicated'' (or controversial) therapies:
	**[[Antibiotics]] (unless giving steroids]]		**[[Antibiotics]] (unless giving steroids]]
	**[[Activated charcoal]] (may consider when coingestants pose a risk for severe systemic toxicity)		**[[Activated charcoal]] (may consider when coingestants pose a risk for severe systemic toxicity)
	*[[Gastric lavage]]: contraindicated due to potential to cause reflux of caustic agent into esophagus, creating more damage		**[[Gastric lavage]]: contraindicated due to potential to cause reflux of caustic agent into esophagus, creating more damage
	*Dilution with water or milk: causes vomiting, elevating risk for perforation		**Dilution with water or milk: causes vomiting, elevating risk for perforation
	*Neutralization (e.g. with milk or mag citrate): generates excess heat		**Neutralization (e.g. with milk or mag citrate): generates excess heat

	===[[Caustic keratoconjunctivitis\|Ocular exposure]]===		===[[Caustic keratoconjunctivitis\|Ocular exposure]]===
	*Irrigate, immediately and copiously!		*Irrigate, immediately and copiously!

ClaireLewis: /* Clinical Features */

2017-01-15T22:04:38Z

Clinical Features

← Revisión anterior		Revisión del 22:04 15 ene 2017
Línea 9:		Línea 9:
	*Ingestion		*Ingestion
	**All patients with serious esophageal injuries have ''some'' initial sign/symptom		**All patients with serious esophageal injuries have ''some'' initial sign/symptom
	**Dysphagia, odynophagia, [[epigastric]] ~~pain~~, [[vomiting]]		**Dysphagia, odynophagia, [[epigastric pain]], [[vomiting]]
	**Laryngotracheal injury: dysphonia, [[stridor]], respiratory distress		**Laryngotracheal injury: dysphonia, [[stridor]], respiratory distress
	***Occurs via aspiration of caustic or vomitus or inhalation of acidic fumes		***Occurs via aspiration of caustic or vomitus or inhalation of acidic fumes

ClaireLewis at 22:04, 15 January 2017

2017-01-15T22:04:23Z

@@ Línea 5: / Línea 5: @@
 ==Clinical Features==
-*Can be systemically absorbed and → [[metabolic acidosis]], hemolysis, AKI
+*Can be systemically absorbed and → [[metabolic acidosis]], hemolysis, [[AKI]]
-*Dermal [[burns]]
+*Dermal [[caustic burns]]
 *Ingestion
 **All patients with serious esophageal injuries have ''some'' initial sign/symptom
@@ Línea 13: / Línea 13: @@
 ***Occurs via aspiration of caustic or vomitus or inhalation of acidic fumes
 *[[Smoke inhalation injury|inhalation injury]]
-**PVCs and other [[arrythmias]]
+**PVCs and other [[arrhythmias]]
 **Delayed onset (2-12 hours) [[pulmonary edema]]
 **[[Dyspnea]], [[chest pain]]
@@ Línea 22: / Línea 22: @@
 ==Differential Diagnosis==
 ==Evaluation==
 ==Management==
 ==Disposition==
 ==See Also==
 ==External Links==

← Revisión anterior		Revisión del 22:06 15 ene 2017
Línea 88:		Línea 88:

	==See Also==		==See Also==
	*[[Caustic burns]], [[Caustic ~~injection~~]], [[Caustic keratoconjunctivitis]], [[Inhalation exposure]]		*[[Caustic burns]], [[Caustic ingestion]], [[Caustic keratoconjunctivitis]], [[Inhalation exposure]]

	==External Links==		==External Links==