Hydrochloric acid poisoning
Definition
Hydrochloric acid is a clear, poisonous liquid. It is a caustic chemical and highly corrosive, which means it immediately causes severe damage to tissues, such as burning, on contact. This article discusses poisoning from swallowing or breathing in hydrochloric acid.
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 the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Poisonous Ingredient
Hydrochloric acid
Where Found
Hydrochloric acid is found in:
- Certain fertilizers
- Pool chemicals
- Soldering fluxes
- Toilet bowl and other porcelain cleaners
This list is not all inclusive.
Symptoms
Symptoms from swallowing hydrochloric acid may include:
- Mouth and throat burn, causing severe pain
- Drooling
- Breathing difficulty due to swelling of throat
- Severe abdominal pain
- Bloody vomiting
- Severe chest pain
- Fever
- Rapid drop in blood pressure (shock)
Symptoms from breathing in hydrochloric acid:
- Bluish color to lips and fingernails
- Chest tightness
- Choking
- Coughing up blood
- Dizziness
- Low blood pressure
- Rapid pulse
- Shortness of breath
- Weakness
If the poison touches your skin or eyes, you may have:
- Blisters
- Burns
- Pain
- Vision loss
Home Care
Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care professional.
If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.
If the chemical was swallowed, immediately give the person water or milk, unless instructed otherwise by a health care provider. DO NOT give water or milk if the person is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.
If the person breathed in the poison, immediately move him or her to fresh air.
Before Calling Emergency
If possible, determine the following information:
- Person's age, weight, and condition (for example, is the person awake or alert?)
- Name of the product (ingredients and strength, if known)
- When it was swallowed or inhaled
- How much was swallowed or inhaled
However, DO NOT delay calling for help if this information is not immediately available.
Poison Control
Your local poison control 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 national hotline 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 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.
What to Expect at the Emergency Room
The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The person may receive:
- Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
- Blood and urine tests
- Camera down the throat to see burns in the airway (bronchoscopy)
- Camera down the throat to see burns in the esophagus and stomach (endoscopy)
- Chest x-ray
- CT (computerized axial tomography, or advanced imaging) scan
- ECG (electrocardiogram, or heart tracing)
- Fluids through a vein (IV)
- Medicines to treat symptoms
- Tube through the nose into the stomach to suction (aspirate) any remaining acid if the victim is seen shortly after ingesting the poison
Note: Activated charcoal does not effectively treat (adsorb) hydrochloric acid.
For skin exposure, treatment may include:
- Surgical removal of burned skin (debridement)
- Transfer to a hospital that specializes in burn care
- Washing of the skin (irrigation), possibly every few hours for several days
Outlook (Prognosis)
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.
The person may need to stay in the hospital for more treatment. Swallowing poison can have severe effects on many parts of the body. Extensive damage to the mouth, throat, and stomach are possible. Holes (perforations) in the esophagus and stomach may result in serious infections in the chest and abdominal cavities, which may result in death. Surgery may be needed to repair the perforations. Cancer of the esophagus is a high risk in people who live after ingesting hydrochloric acid.
References
Hoyte C. Caustics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 143.
Kuschner WG, Blanc PD. Acute responses to toxic exposures. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 103.
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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