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Sulfuric acid poisoning

Battery acid poisoning; Hydrogen sulfate poisoning; Oil of vitriol poisoning; Matting acid poisoning; Vitriol brown oil poisoning

Sulfuric acid is a very strong chemical that is corrosive. Corrosive means it can cause severe burns and tissue damage when it comes into contact with the skin or mucous membranes. This article discusses poisoning from sulfuric acid.

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 the local emergency number (such as 911), or the local poison control center can be reached directly by calling the toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

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Poisonous Ingredient

Sulfuric acid

Where Found

Sulfuric acid is found in:

• Car battery acid
• Certain detergents
• Chemical munitions
• Some fertilizers
• Some toilet bowl cleaners

Note: This list may not be all-inclusive.

Symptoms

Initial symptoms include severe pain on contact.

Symptoms from swallowing may also include:

• Breathing difficulty due to throat swelling
• Burns in the mouth and throat
• Drooling
• Fever
• Rapid development of low blood pressure (shock)
• Severe pain in the mouth and throat
• Speech problems
• Vomiting, with blood
• Vision loss

Symptoms from breathing in the poison may include:

• Bluish skin, lips, and fingernails
• Breathing difficulty
• Body weakness
• Chest pain (tightness)
• Choking
• Coughing
• Coughing up blood
• Dizziness
• Low blood pressure
• Rapid pulse
• Shortness of breath

Symptoms from skin or eye contact may include:

• Skin burning, drainage, and pain
• Eye burning, drainage, and pain
• Vision loss

Home Care

Do not make a person throw up. Seek medical help right away.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the chemical was swallowed, immediately give the person water or milk. Do not give water or milk if the person is having symptoms that make it hard to swallow. These may include vomiting, convulsions, or a decreased level of alertness.

If the person breathed in the poison, immediately move them to fresh air.

Before Calling Emergency

Get the following information, if possible:

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

Take the container with you to the emergency room.

Poison Control

Your local poison control center can be reached directly by calling the toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline 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. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

The health care provider will measure and monitor the person's vital signs, including:

• Oxygen saturation
• Temperature
• Pulse
• Breathing rate
• Blood pressure

Symptoms will be treated as appropriate. The person may receive:

• Blood tests
• Airway and/or breathing support -- including oxygen via external delivery device or endotracheal intubation (placement of a breathing tube through the mouth or nose into the airway) with placement on a ventilator (life support breathing machine).
• Electrocardiogram (ECG)
• Endoscopy -- a camera is used to examine down the throat to see burns in the esophagus and the stomach
• Laryngoscopy or bronchoscopy -- a device (laryngoscope) or camera (bronchoscope) is used to examine the throat and airway to see burns
• Eye irrigation
• Fluids through a vein (IV)
• Medicines to treat symptoms
• Surgery to repair any tissue damage
• Surgical removal of burned skin (skin debridement)
• Washing of the skin (irrigation), perhaps every few hours for several days
• X-rays of the chest and abdomen

Outlook (Prognosis)

How well a person does depends on how fast the poison is diluted and neutralized. Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach is possible. The ultimate outcome depends on how much damage there is.

Damage continues to occur to the esophagus and stomach for several weeks after the poison is swallowed, which can lead to serious infection and failure of multiple organs. Treatment may require the removal of part of the esophagus and stomach.

If the poison enters the lungs, serious damage may occur, both immediately and long-term.

Swallowing the poison may cause death. It may occur as long as a month after the poisoning.

References

Hoyte C. Caustics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 143.

Mazzeo AS. Burn care procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 38.

Review Date: 7/6/2022  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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