NOTEThere are two important categories of sub-stances which act locally on the skin, eyes, ormucous membranes and cause damagethrough direct contact. These are acids (cor-rosives) and bases (caustics). Although thesetwo 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 termfor 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 genericand not the specific. When specifically dis-cussing acids or bases in this chapter, theterms “acid” or “base” (or “alkali”), respec-tively, will be used.Ingested substances can be absorbed into the bodyand transported to a distant site with systemicaction(s). In such situations, the poisonous substancemay cause few effects—or even no effect—at the siteof contact or absorption, but it may have severesystemic effects.Ingestion of substances that do not produce localeffects can be divided into two types:nontoxic substances (latex paint, dirt, silica gel,spider plant), andpotentially toxic substances (poisonous fish,medications, heavy metals (lead, mercury),pesticides, and personal care products).Episodes involving the ingestion of non-toxicsubstances do not require decontamination of the gut.(Swallowing a non-toxic foreign body, however, like acoin or button battery in a child, may result in chokingand require prompt medical intervention.)The toxicity range of absorbed poisons extendsfrom essentially non-toxic to extremely toxic(remember Paracelsus’ “dose”). Ingestion ofsubstances with a low order of toxicity may result inthe 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 vomitingto discourage a patient from repeating avoluntary ingestion again.NoncorrosivesThe many different noncorrosive substances havethe common characteristic of irritating the stomach.They produce nausea, vomiting, convulsions, andsevere abdominal pain. The victim may complain of astrange taste, and the lips, tongue, and mouth may lookdifferent than normal. Shock may also occur.Examples of noncorrosives are listed in table 5-2.First aid for most forms of noncorrosive poisoningcenters on quickly emptying the stomach of theirritating substance. The following steps are suggested:1. Maintain an open airway. Be prepared to giveartificial ventilation.2. Dilute the poison by having the consciousvictim 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 foremptying the contents of the stomach. It is5-4Irritant Sources of ContactArsenicDyes, insecticides, paint, printer=s ink,wood preservativesCopperAntifoulant paint, batteries, canvaspreservative, copper plating, electro-plating, fungicides, insecticides, solder-ing, wood preservativesIodine AntisepticsMercury Bactericides, batteries, dental suppliesand appliances, disinfectants, dyes,fungicides, ink, insecticides, labora-tories, photography, wood preserva-tivesPhosphorus Incendiaries, matches, pesticides, ratpoisonSilver nitrateBatteries, cleaning solutions, ink,photographic film, silver polish,solderingZincDisinfectants, electroplating, fungi-cides, galvanizing, ink, insecticides,matches, metal plating and cutting,paint, soldering, wood preservativesTable 5-2.—Common Stomach Irritants and Possible Sourcesof Contact
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