NOTE There are two important categories of sub- stances which act locally on the skin, eyes, or mucous membranes and cause damage through direct contact. These are acids (cor- rosives) and bases (caustics). Although these two categories are distinct and there are sig- nificant differences in the physiological ef- fects of contact with them, the term “corrosive” is recognized as a generic term for the action that occurs upon contact with ei- ther an acid or a base. The terms “corrosive” and “noncorrosive,” as used in this chapter, should be understood to represent the generic and not the specific. When specifically dis- cussing acids or bases in this chapter, the terms “acid” or “base” (or “alkali”), respec- tively, will be used. Ingested substances can be absorbed into the body and transported to a distant site with systemic action(s). In such situations, the poisonous substance may cause few effects—or even no effect—at the site of contact or absorption, but it may have severe systemic effects. Ingestion of substances that do not produce local effects can be divided into two types:  nontoxic substances (latex paint, dirt, silica gel, spider plant), and  potentially toxic substances (poisonous fish, medications, heavy metals (lead, mercury), pesticides, and personal care products). Episodes involving the ingestion of non-toxic substances do not require decontamination of the gut. (Swallowing a non-toxic foreign body, however, like a coin or button battery in a child, may result in choking and require prompt medical intervention.) The toxicity range of absorbed poisons extends from essentially non-toxic to extremely toxic (remember Paracelsus’ “dose”). Ingestion of substances with a low order of toxicity may result in the production of only minor systemic effects (nausea, vomiting, diarrhea), effects that are mild, self-limiting, and do not require significant medical intervention. NOTE: Do not induce unnecessary vomiting to discourage a patient from repeating a voluntary ingestion again. Noncorrosives The many different noncorrosive substances have the common characteristic of irritating the stomach. They produce nausea, vomiting, convulsions, and severe abdominal pain. The victim may complain of a strange taste, and the lips, tongue, and mouth may look different than normal. Shock may also occur. Examples of noncorrosives are listed in table 5-2. First aid for most forms of noncorrosive poisoning centers on quickly emptying the stomach of the irritating substance. The following steps are suggested: 1. Maintain an open airway. Be prepared to give artificial ventilation. 2. Dilute the poison by having the conscious victim drink one to two glasses of water or milk. 3. Empty the stomach using emetic, gastric lavage, adsorbent, and/or cathartic. a. Giving an emetic is a preferred method for emptying the contents of the stomach. It is 5-4 Irritant Sources of Contact Arsenic Dyes, insecticides, paint, printer=s ink, wood preservatives Copper Antifoulant paint, batteries, canvas preservative, copper plating, electro- plating, fungicides, insecticides, solder- ing, wood preservatives Iodine Antiseptics Mercury Bactericides, batteries, dental supplies and appliances, disinfectants, dyes, fungicides, ink, insecticides, labora- tories, photography, wood preserva- tives Phosphorus Incendiaries, matches, pesticides, rat poison Silver nitrate Batteries, cleaning solutions, ink, photographic film, silver polish, soldering Zinc Disinfectants, electroplating, fungi- cides, galvanizing, ink, insecticides, matches, metal plating and cutting, paint, soldering, wood preservatives Table 5-2.—Common Stomach Irritants and Possible Sources of Contact