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Sodium bisulfate poisoning

Definition

Sodium bisulfate is a dry acid that may be harmful if swallowed in large amounts. This article discusses poisoning from swallowing sodium bisulfate.

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 your local emergency number (such as 911), or your local poison 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

Sodium bisulfate

Where Found

Sodium bisulfate is found in:

  • Household cleaners
  • Metal finishing
  • Swimming pool pH additives

Note: This list may not be all inclusive.

Symptoms

Symptoms from swallowing more than a tablespoon (15 milliliters) of this acid may include:

  • Breathing difficulty
  • Burning pain in the mouth
  • Chest pain from burns of the esophagus (swallowing tube)
  • Diarrhea
  • Drooling
  • Gaggling sensation
  • Vomiting, sometimes bloody
  • Severe low blood pressure (shock) causing weakness

If the chemical touches your skin, symptoms may include:

  • Blisters
  • Burns
  • Painful, red skin

If it gets in your eyes, you may have:

  • Decreased vision
  • Eye pain
  • Eye redness and tearing

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 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 chemical is on the skin or in the eyes, flush with lots of water (at least 2 quarts [1.9 liters]) for at least 15 minutes.

If the person breathed in the poison, immediately move him or her to fresh air.

Before Calling Emergency

The following information is helpful for emergency assistance:

  • Person's age, weight, and condition
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed

However, DO NOT delay calling for help if this information is not immediately available.

Poison Control

Your local poison 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 hotline number 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. You can call 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. Symptoms will be treated as appropriate. The person may receive:

  • Airway support, including oxygen, breathing tube through the mouth (intubation),and ventilator (breathing machine)
  • Blood and urine tests
  • Camera down the throat to see burns in the esophagus (food pipe) and the stomach (endoscopy)
  • Chest x-ray
  • EKG (electrocardiogram, or heart tracing)
  • Fluids through the vein (intravenous or IV)
  • Medicines to treat symptoms

For skin exposure, treatment may include:

  • Irrigation (washing of the skin), perhaps every few hours for several days
  • Skin debridement (surgical removal of burned skin)
  • Transfer to a hospital that specializes in burn care

Hospital admission may be necessary to continue treatment. Surgery may be required if the esophagus, stomach or intestine have developed holes (perforation) from exposure to the acid.

Outlook (Prognosis)

How well a person does depends on how rapidly the sodium bisulfate was diluted and neutralized. There is a good chance of recovery if proper treatment is given soon after the poison was swallowed. Without prompt treatment, extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible, depending on how exposure occurred. Holes (perforation) in the esophagus and stomach may result in serious infections in both the chest and abdominal cavities, which may result in death.

Damage to the esophagus may occur as late as 2 to 3 weeks after swallowing the poison. Death may occur up to 1 month or longer after swallowing the poison. Those who recover may have continued stomach or esophagus problems.

References

US National Library of Medicine; Specialized Information Services; Toxicology Data Network. Sodium bisulfite. Updated August 23, 2005. toxnet.nlm.nih.gov. Accessed February 9, 2017.

Wax PM, Young A. Caustics. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 153.

Review Date:1/31/2017
Reviewed By:Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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