cleaning products

• bleach

  • low toxicity (10%)

  • rarely infest enough as bleach extremely unpalatable

  • \<100mL of house hold bleach unlikely to cause serious adverse effects

  • if develop symptoms -> hospital

    • nausea

    • vomiting

    • diarrhoea

  • industrial bleeach (50%)

    • oesophageal injury ?

• Acid/alkali

  • dishwasher powder

  • drain cleaner

  • oven cleaner

  • oesphogeal injury can occur wihtou tobvious lip or oral burns

  • any:

    • stridor

    • dyspnoea

    • dysphonia

    • drooling

    • vomiting

  • suggest serious injury to airway or gastro-oesophageal tract

  • child referred urgently to hosptial

  • NBM

• Ammonia

  • hosuehold cleaners

    • doens’t cause corrosive injury

    • occ. exposure to more concentrated ammonia occurs

  • manage as per acid/alkali

• Ammonia gas

  • highly irritant to mucosal surfaces

  • relased when ammonia mixed with strong alkali

• Superglue (cyanoacrylate)

  • exposure not lethal

  • painful/distressing

  • general principles

    • immerse bonded surfaces in warm soapy water

    • attempt to peel/roll surfaces with aid of a blunt edge

      • don’t try and pull surfaces apart with a direct opposing action

    • attempt to remove glue with acetone

      • not mouth or eye

  • if lips

    • irrigate with warm water

    • encourage maximum wetting from saliva and pressure from tongue inside mouth

    • peel/roll lips apart

  • if eyelids

    • irrigate with warm water

    • eyelids rolling lids

    • overnight wet eye patch

      • followed opthalmology review

• Nail polish remover

  • composed of different products

  • management supportive

  • charcoal recommended

  • ethyl acetate has local irritant effect to skin, eyes, mucous membranes

• Anti-freeze (ethylene glycol)

  • rapidly absorbed

  • signs and symptoms similar to ethanol intoxication

    • nystagmus

    • drowsiness

    • nausea

    • vomiting

  • cardiorespiratory features may develop

    • shock

    • seiures

    • coma

    • renal failure

  • all symptomatic whom exposure level unknown

  • metabolic acidosis

  • minor infestion (small taste)

    • don’t require hospital evaluation can be observed unless symptoms develop

• petrol

  • mild transient nausea dn vomiting

  • observe in the community

  • =dont’ dilute or induce emesis

    • increase risk of pneumonitis

  • dermal exposure

    • decontaminated with soap and water

• Rodenticides (long acting coumarin anticoagulant)

  • sinlge pellet doens’t require INR or medical review

  • seek medical attention if child develops mucosal bleeding or bruising

• Glyphosate

  • diluted preparations = little concen

    • mild gastrointestinal symptoms

  • concentrated

    • nausea

    • vomiting

    • diarrhoea

    • abdominal pain

  • oropharyngeal/oesophagela erosis, aspirtation, pneumonia, hypotension

Pyrethroids

• insecticides = synthetic modifications of natural

• high selective toxicity for insects compared to mammals

  • higher insect nerve sensitivity

  • lower mammalian skin absorption

  • more effecient mamalian hepatic metabolism

• ion channel toxins

  • interfere with function of nervous system

  • modify gating characteristics

• wide spectrum of signs and symptoms

  • parathesia, increase salivations, seizures, death

• allergic reactions

  • synthetic

• permethrin associated with low risk of toxicity