Automatic dishwasher soap poisoning: MedlinePlus Medical Encyclopedia

P Automatic dishwasher soap poisoning refers to illness that occurs when you swallow soap used in automatic dishwashers or when the soap contacts the face.
P This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

T Poisonous Ingredient
P Automatic dishwasher products contain various soaps. Potassium carbonate and sodium carbonate are the most common.

T Where Found
P The poisonous ingredients are found in automatic dishwasher soaps.

T Symptoms
P Symptoms of automatic dishwasher soap poisoning can affect many parts of the body.
P EYES, EARS, NOSE, AND THROAT 
- Severe pain in the throat
- Severe pain or burning in the nose, eyes, ears, lips, or tongue
- Loss of vision
- Throat swelling (which may also cause breathing trouble)
P HEART AND BLOOD CIRCULATION 
- Low blood pressure -- develops quickly
- Collapse
- Severe change in blood acid levels, which can lead to organ damage
P LUNGS
- Breathing difficulty (from breathing in the poison)
P SKIN
- Irritation
- Burns
- Necrosis (tissue death) in the skin or tissues underneath
P STOMACH AND INTESTINES
- Severe abdominal pain
- Vomiting, may be bloody
- Burns of the esophagus (food pipe)
- Blood in the stool

T Home Care
P Seek immediate emergency medical help. DO NOT make the person throw up.
P If the soap is in the eyes, flush with lots of water for at least 15 minutes.
P If the soap was swallowed, have the person immediately drink water or milk.

T Before Calling Emergency
P Determine the following information:
- The person's age, weight, and condition
- The name of the product (ingredients and strengths, if known)
- The time it was swallowed
- The amount swallowed

T Poison Control
P Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions.
P This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
P Take the container with you to the hospital, if possible.

T What to Expect at the Emergency Room
P The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood and urine tests will be done. Symptoms will be treated as needed. The person may receive:
- Activated charcoal to help prevent the remaining poison from being absorbed into the stomach and digestive tract.
- Airway and breathing support, including oxygen. In extreme cases, a tube may be passed through the mouth into the lungs to prevent aspiration. A breathing tube (ventilator) would then be needed.
- Blood transfusion if severe blood loss has occurred.
- Chest x-ray.
- EKG (electrocardiogram, or heart tracing).
- Fluids through a vein (IV).
- Endoscopy -- a camera down the throat to see burns in the esophagus and stomach.
- Medicines (laxatives) to move the poison quickly through the body.
- Tube through the mouth into the stomach to wash out the stomach (gastric lavage). This is rare.
- Medicines to treat symptoms, such as nausea and vomiting, or those of an allergic reaction, such as swelling of the face or mouth or wheezing (diphenhydramine, epinephrine, or steroids).

T Outlook (Prognosis)
P How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery.
P Swallowing poisons can have severe effects on many parts of the body. Damage can continue to occur to the esophagus and stomach for several weeks after the product is swallowed. Death may occur up to a month after the poisoning.
P However, most cases of swallowing dishwasher soap are not that harmful. Over-the-counter household products are made to be safe for people and the environment.

T References
P Harchelroad FP Jr, Rottinghaus DM. Chemical burns. In: Tintinalli JE, Stapczynski JS, Ma OJ, Cline DM, Cydulka RK, Meckler GD, eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, NY: McGraw-Hill Education/Medical; 2011:chap 211.
P Kulig K. General approach to the poisoned patient. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 147.

T Review Date 10/2/2016
P Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

