Sulphuric Acid (Oil of Vitriol)

Pure sulphuric acid is a colowebsiteess, odowebsiteess, heavy, oily, hygroscopic, non-fuming liquid. It charrs and blackens skin, clothes and organic matter.
Commercial sulphuric acid is usually brown or dark in colour.

Route :
Ingestion, Contact
Fatal Dose :
10-15 ml
Fatal Period :
12-24 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} The tongue is swollen and is brown or black in colour.
2} The teeth are chalky white in appearance.
3} The lips are swollen, corroded and black.
4} Brown or black streaks may be found extending from the angle of the mouth to the sides of the chin, and sometimes to the front of the neck` due to flow of the acid.
5} Immediate intense burning pain in the digestive tract. The most common presenting symptom is pharyngeal pain.
6} Vomiting of dark brown or black matter, mucoid, strongly acidic and may contain shreds of the charred wall of the stomach.
7} There is intense thirst but any attempt to drink causes vomiting.
8} There is difficulty in breathing {dyspnoea}` the voice becomes hoarse and husky.
9} There is stridor, dysphagia {difficulty in swallowing} and odynophagia {pain on swallowing}.

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.

Sulphuric Acid (Oil of Vitriol)

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