1/ #tweetorial
π Caustic Ingestions - Key Points
β‘οΈ Serious ingestions can immediately result in perforation, shock, and even death.
β‘οΈ Caustic materials cause tissue injury by chemical reaction.
- Read More : manualofmedicine.com/topics/emergenβ¦
#meded #foamed #medtwitter
π Caustic Ingestions - Key Points
β‘οΈ Serious ingestions can immediately result in perforation, shock, and even death.
β‘οΈ Caustic materials cause tissue injury by chemical reaction.
- Read More : manualofmedicine.com/topics/emergenβ¦
#meded #foamed #medtwitter
2/
β‘οΈ Acids cause coagulative necrosis, which results in a self-limiting burn pattern
β‘οΈ Alkaline materials induce liquefactive necrosis with diffusion into deeper layers of the injured mucosa. Even low concentrations of alkaline ingestion can cause extensive injury.
β‘οΈ Acids cause coagulative necrosis, which results in a self-limiting burn pattern
β‘οΈ Alkaline materials induce liquefactive necrosis with diffusion into deeper layers of the injured mucosa. Even low concentrations of alkaline ingestion can cause extensive injury.
3/
β‘οΈ Caustic Ingestion can provoke injury from the mouth, the airway, down through the esophagus to the small intestine.
β‘οΈ Long-term complications can lead to strictures and an increased risk of esophageal cancer.
β‘οΈ Caustic Ingestion can provoke injury from the mouth, the airway, down through the esophagus to the small intestine.
β‘οΈ Long-term complications can lead to strictures and an increased risk of esophageal cancer.
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β³οΈ Symptoms and Signs
π Obvious burns to the lips, mouth, and oropharynx
π Laryngeal or epiglottic edema
π Esophageal perforation
π In children: consider in those who present with symptoms of anaphylaxis that do not improve with treatment.
β³οΈ Symptoms and Signs
π Obvious burns to the lips, mouth, and oropharynx
π Laryngeal or epiglottic edema
π Esophageal perforation
π In children: consider in those who present with symptoms of anaphylaxis that do not improve with treatment.
5/
β‘οΈ Laryngeal or epiglottic edema may present with:
π stridor
π dysphonia
π hoarseness
π dyspnea
π drooling
π respiratory distress and impending airway obstruction
β‘οΈ Laryngeal or epiglottic edema may present with:
π stridor
π dysphonia
π hoarseness
π dyspnea
π drooling
π respiratory distress and impending airway obstruction
6/
β‘οΈ Esophageal perforation and may present with:
π abdominal pain
π rigidity
π substernal chest pain
π back pain
β‘οΈ Esophageal perforation and may present with:
π abdominal pain
π rigidity
π substernal chest pain
π back pain
7/
β³οΈ Diagnosis
β‘οΈ Endoscopy is indicated within 24 to 48 hours for:
π any patient who is symptomatic (or asymptomatic with an alkali),
π children refusing to eat or drink
π patients with altered mental status
β³οΈ Diagnosis
β‘οΈ Endoscopy is indicated within 24 to 48 hours for:
π any patient who is symptomatic (or asymptomatic with an alkali),
π children refusing to eat or drink
π patients with altered mental status
8/
β³οΈ What to avoid ?
π Avoid agents that induce vomiting, as this can lead to esophageal perforation.
π Avoid neutralizing the substance by using a weak acid or base.
π Avoid diluents.
π Avoid activated charcoal, because of poor adsorption and endoscopic interference.
β³οΈ What to avoid ?
π Avoid agents that induce vomiting, as this can lead to esophageal perforation.
π Avoid neutralizing the substance by using a weak acid or base.
π Avoid diluents.
π Avoid activated charcoal, because of poor adsorption and endoscopic interference.
9/
β³οΈ Treatment
π Evaluate the airway first
π Place the patient NPO
π Nasogastric tube suction may be beneficial with large-volume liquid acid ingestions
π Aggressive hydration and medications to decrease acid production are given to prevent reflux associated injury
β³οΈ Treatment
π Evaluate the airway first
π Place the patient NPO
π Nasogastric tube suction may be beneficial with large-volume liquid acid ingestions
π Aggressive hydration and medications to decrease acid production are given to prevent reflux associated injury
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