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Hydrochloric acid poisoning

Hydrochloric acid is a clear, poisonous liquid. It is a caustic chemical and highly corrosive, which means it immediately causes severe damage to tissues, such as burning, on contact. This article discusses poisoning from swallowing or breathing in hydrochloric 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 national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

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Poisonous Ingredient

Hydrochloric acid

Where Found

Hydrochloric acid is found in:

Certain fertilizers
Pool chemicals
Soldering fluxes
Toilet bowl and other porcelain cleaners

This list is not all inclusive.

Symptoms

Symptoms from swallowing hydrochloric acid may include:

Mouth and throat burn, causing severe pain
Drooling
Breathing difficulty due to swelling of throat
Severe abdominal pain
Bloody vomiting
Severe chest pain
Fever
Rapid drop in blood pressure (shock)

Symptoms from breathing in hydrochloric acid:

If the poison touches your skin or eyes, you may have:

Blisters
Burns
Pain
Vision loss

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

Before Calling Emergency

If possible, determine the following information:

Person's age, weight, and condition (for example, is the person awake or alert?)
Name of the product (ingredients and strength, if known)
When it was swallowed or inhaled
How much was swallowed or inhaled

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

Poison Control

Your local poison control 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 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 provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The person may receive:

Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
Blood and urine tests
Camera down the throat to see burns in the airway (bronchoscopy)
Camera down the throat to see burns in the esophagus and stomach (endoscopy)
Chest x-ray
CT (computerized axial tomography, or advanced imaging) scan
ECG (electrocardiogram, or heart tracing)
Fluids through a vein (IV)
Medicines to treat symptoms
Tube through the nose into the stomach to suction (aspirate) any remaining acid if the victim is seen shortly after ingesting the poison

Note: Activated charcoal does not effectively treat (adsorb) hydrochloric acid.

For skin exposure, treatment may include:

Surgical removal of burned skin (debridement)
Transfer to a hospital that specializes in burn care
Washing of the skin (irrigation), possibly every few hours for several days

Outlook (Prognosis)

How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery.

The person may need to stay in the hospital for more treatment. Swallowing poison can have severe effects on many parts of the body. Extensive damage to the mouth, throat, and stomach are possible. Holes (perforations) in the esophagus and stomach may result in serious infections in the chest and abdominal cavities, which may result in death. Surgery may be needed to repair the perforations. Cancer of the esophagus is a high risk in people who live after ingesting hydrochloric acid.

References

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

Kuschner WG, Blanc PD. Acute responses to toxic exposures. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 103.

Review Date: 1/2/2023

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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