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4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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Drug

Treatment Details

Hydrochloric Acid (Muriatic Acid)

It is a pungent, colowebsiteess, fuming liquid.

Route : Ingestion, Contact

Fatal dose : 15 to 20 ml

Fatal Period : 12 to 24 hours

Mechanism of action : An exothermic chemical reaction occurs when a mineral acid comes into contact with moist skin. The heat liberated together with the corrosion causes coagulation necrosis. This crust may prevent further penetration of the acid. It has no remote actions, all of its actions are local.

Clinical picture : 1} It is less corrosive in its action than sulphuric acid and therefore the manifestations are milder.
2} It does not usually corrode or seriously damage the skin, but it readily destroys mucous membranes. The mucous membrane is at first grey or grey-white, and later becomes brown or black due to the production of acid haematin.
3} Inhalation of fumes causes intense irritation of throat and lungs with symptoms of suffocation, coughing, dyspnoea and cyanosis.
4} Constant exposure to fumes produces chronic poisoning characterised by coryza, conjunctivitis, corneal ulcer, pharyngitis, bronchitis, inflammation of the gums and loosening of the teeth.

Treatment : 1} Gastric lavage and emetics are contra-indicated.
2} The acid should be immediately neutralised or diluted in situ by giving one-fourth litre of water or milk or milk of magnesia or lime water or soap suds or aluminium hydroxide gel` if the patient is seen within 30 minutes of ingestion.
3} Alkaline carbonates and bicarbonates which liberate carbon dioxide are contra-indicated since they cause gastric distension and sometimes rupture.
4} Give a demulcent: olive oil, milk, egg-whites, starch water, mineral oil, melted butter.
5} Prednisolone 60 mg, day may be given in divided doses to prevent oesophageal stricture and counter shock.
6} Tracheostomy if there is glottic oedema.
7} Give nothing by mouth.
8} Skin burns are washed with large amounts of water and a paste of magnesium oxide or sodium bicarbonate is applied.
9} Eye burns are irrigated with water or sodium bicarbonate solution for 10-15 minutes. A suspended i.v. bag that administers low pressure irrigation is ideal.

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

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