First aid for strong acid and alkali poisoning?

KPSC Staff Nurse - 2018

Medical Surgical Nursing

Easy

Appeared in: KPSC Staff Nurse - 2018

Explanation

Inducing vomiting is strictly contraindicated after ingesting a corrosive substance like a strong acid or alkali.
Vomiting forces the caustic agent back up through the esophagus, pharynx, and mouth, causing a second wave of chemical burns to these tissues.
This action dramatically increases the risk of severe complications, including esophageal perforation, aspiration of the chemical into the lungs, and development of scar tissue (strictures) during healing.

Option A: Gastric lavage involves inserting a tube into the stomach. In a patient who has ingested a corrosive, the esophageal and gastric tissues are fragile and can be easily perforated by the tube, leading to a medical emergency.
Option B: This is a physical method to induce vomiting. As vomiting is contraindicated for corrosive poisoning, any action that triggers it is incorrect and harmful.
Option C: Swallowing a concentrated salt solution is an outdated and dangerous method to induce vomiting. It does not effectively empty the stomach and can cause severe, life-threatening hypernatremia (high sodium levels in the blood), leading to seizures and brain damage.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain First aid management of corrosive poisoning as background academic context rather than a clinical decision trigger.
Nurses must immediately recognize the signs of corrosive ingestion and prevent well-intentioned but harmful first aid attempts like inducing vomiting.
The priority nursing actions are to maintain a patent airway, assess for signs of respiratory distress from laryngeal edema, stabilize the patient, and prepare for urgent transport to a facility for endoscopy and specialized care.
What if? If the ingested substance was a non-corrosive poison like an overdose of tablets (e.g., paracetamol), then administration of activated charcoal might be indicated within a specific time frame (usually 1 hour) to absorb the toxin. However, inducing vomiting is still generally avoided.

How to Approach the Question

First, identify the substance involved in the poisoning: 'strong acid and alkali'. Recognize these as corrosive agents.
Recall the primary danger of corrosives: they burn and destroy tissue on contact.
Apply the core principle of first aid for corrosives: avoid any action that causes re-exposure of the upper gastrointestinal tract to the substance.
Evaluate each option against this principle. 'Gastric lavage', 'Tickling back of pharynx', and 'Swallowing concentrated salt solution' are all actions that either risk perforation or are designed to induce vomiting (re-exposure).
Therefore, the only safe and correct action is to 'Do not induce vomiting'.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 129-131

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 754-756