Alternative Names: Bleach; Clorox; Carrel-Dakin solution

Poisonous Ingredient:

Sodium hypochlorite

Where Found:

• Chemical used to add chlorine to swimming pools
• Some bleaching solutions
• Disinfectants
• Water purifiers

Note: This list may not be all inclusive.

Symptoms:

Watered-down (diluted) sodium hypochlorite generally causes only mild stomach irritation. Swallowing larger amounts can cause more serious symptoms.�

NEVER mix ammonia with sodium hypochlorite (bleach or bleach-containing products). This common household error produces�a toxic gas that can cause choking and serious breathing problems. �

Symptoms of sodium hypochlorite poisoning�may include:

• Body as a whole
  • Pain in the mouth
  • Possible burns on esophagus
• Respiratory
  • Coughing (from the fumes)
  • Possible aspiration into lungs
• Eyes, ears, nose, and throat
  • Pain in the throat
  • Burning, red eyes
  • Gagging sensation
• Skin
  • Irritation of the exposed area
  • Burns
  • Blistering
• Gastrointestinal
  • Stomach or abdominal pain
  • Vomiting
• Heart and blood vessels
  • Low blood pressure
  • Bradycardia (slow heartbeat)
  • Chest pain
  • Shock
• Nervous system
  • Delirium
  • Coma

Home Treatment:

DO NOT INDUCE VOMITING.

If the chemical is on the skin or eyes, wash with lots of water.

If the chemical was swallowed, give milk or water for dilution.

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:

If you suspect possible poisoning, seek emergency medical care immediately.

For poison control, call 1-800-222-1222 from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the U.S. use this national number.

Take any containers with you to the emergency room, if possible.

What to expect at the emergency room:

Some or all of the following procedures may be performed:

For swallowed poison

• Placement of a tube down the nose and into the stomach (a nasogastric tube, or an NG tube) to wash out the stomach
• Activated charcoal administration
• Endoscopy -- the placement of a camera down the throat to see the extent of burns to the esophagus and the stomach.
• Give IV fluids
• Admission to the hospital
• Give an antidote
• Treat the symptoms

For inhaled poisons

• A breathing tube may need to be inserted
• Oxygen
• Admission to the hospital or to the intensive care unit
• Bronchoscopy (inserting a camera down the throat into the airway to evaluate the extent of burns to the airway and lungs)

For skin exposure

• Irrigation (washing of the skin), perhaps every few hours for several days
• Skin debridement (surgical removal of burned skin)
• Admission or transfer to a hospital that specializes in burn care

Expectations (prognosis):

How well a patient does depends on how rapidly the sodium hypochlorite was diluted and neutralized. There is a good chance of recovery if proper treatment is given soon after the poison was swallowed. Without prompt treatment, extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible, depending on how exposure occurred. The ultimate outcome depends on the extent of this damage.

References:

Ford MD,�Clinical Toxicology.�1st ed. Philadelphia, Pa: WB Saunders; 2001:753.

Agabiti N, Ancona C, Forastiere F, et al. Short term respiratory effects of acute exposure to chlorine due to a swimming pool accident. Occup Environ Med. 2001 Jun;58(6):399-404.

Lambert H, Manel J, Gabrion I. Poisoning by household products. Rev Prat. 2000 Feb 15;50(4):365-71.