Sodium hydroxide poisoning: MedlinePlus Medical Encyclopedia

P Sodium hydroxide is a very strong chemical. It is also known as lye and caustic soda. This article discusses poisoning from touching, breathing in (inhaling), or swallowing sodium hydroxide.
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 Sodium hydroxide

T Where Found
P Sodium hydroxide is found in many industrial solvents and cleaners, including products to strip floors, brick cleaners, cements, and many others.
P It may also be found in certain household products, including:
- Aquarium products
- Clinitest tablets
- Drain cleaners
- Hair straighteners
- Metal polishes
- Oven cleaners
P Other products also contain sodium hydroxide.

T Symptoms
P Below are symptoms of sodium hydroxide poisoning or exposure in different parts of the body.
P AIRWAYS AND LUNGS
- Breathing difficulty (from inhaling sodium hydroxide)
- Lung inflammation
- Sneezing
- Throat swelling (which may also cause breathing difficulty)
P ESOPHAGUS, INTESTINES, AND STOMACH
- Blood in the stool
- Burns of the esophagus (food pipe) and stomach
- Diarrhea
- Severe abdominal pain
- Vomiting, possibly bloody
P EYES, EARS, NOSE, AND THROAT
- Drooling
- Severe pain in the throat
- Severe pain or burning in the nose, eyes, ears, lips, or tongue
- Vision loss
P HEART AND BLOOD
- Collapse
- Low blood pressure (develops rapidly)
- Severe change in blood pH (too much or too little acid in the blood)
- Shock
P SKIN
- Burns
- Hives
- Irritation
- Holes in the skin or tissue under the skin

T Home Care
P Seek medical help right away. DO NOT make a person throw up unless the poison control or a health care provider tells you to.
P If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.
P If the chemical was swallowed, give the person water or milk right away, unless a provider tells you something different. Also, DO NOT give water or milk if the person is having symptoms that make it hard to swallow (such as vomiting, convulsions, or decreased alertness).
P If the person breathed in the poison, move them to fresh air right away.

T Before Calling Emergency
P Have this information ready:
- The person's age, weight, and condition
- The name of the product (ingredients and strength 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. 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.

T What to Expect at the Emergency Room
P Take the container that contains the sodium hydroxide with you to the hospital, if possible.
P The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.
P Treatment depends on how the poisoning occurred. Pain medicine will be given. Other treatments may also be given.
P For swallowed poison, the person may receive:
- Blood tests.
- Chest x-ray.
- ECG (electrocardiogram, or heart tracing).
- Endoscopy. The placement of a camera down the throat to see the extent of burns to the esophagus and the stomach.
- Intravenous fluids (IV, fluids given through a vein).
- Medicines to treat symptoms.
P For inhaled poison, the person may receive:
- Blood tests.
- Breathing support, including oxygen and a tube through the mouth or nose into the lungs.
- Bronchoscopy. Camera is placed down the throat to see burns in the airways and lungs.
- Chest x-ray.
- Intravenous fluids (IV, fluids given through a vein).
- Medicines to treat symptoms.
P For skin exposure, the person may receive:
- Irrigation (washing of the skin). Perhaps every few hours for several days.
- Skin debridement (surgical removal of burned skin).
- Ointments applied to the skin.
P For eye exposure, the person may receive:
- Extensive irrigation to flush out the eye
- Medicines

T Outlook (Prognosis)
P How well a person does depends on how fast the poison is diluted and neutralized. Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible.
P The long-term outcome depends on the extent of this damage. Damage to the esophagus and stomach continues to occur for several weeks after the poison was swallowed. Death may occur as long as a month later.
P Keep all poisons in their original or childproof container, with labels visible, and out of the reach of children.

T Alternative Names
P Lye poisoning; Caustic soda poisoning

T References
P Agency for Toxic Substances and Disease Registry (ATSDR) website. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service. Medical Management Guidelines for Sodium Hydroxide (NaOH). www.atsdr.cdc.gov/MMG/MMG.asp?id=246&tid=45. Updated October 21, 2014. Accessed July 27, 2017.
P Druck J. Chemical burns. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 190.
P Hoyte C. Caustics. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 148.

T Review Date 7/2/2017
P Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

