We examined the question of what determines the toxicity of alkaline solutions - pH, viscosity, or other factors. Our experiments have identified pH measurement as the simplest and most easily measured parameter for determining initial management of caustic ingestions. Viscosity is not a clinically useful measurement. The closer to 14 the pH measures, the more destructive the caustic. Non-lye solutions known to cause esophageal ulceration have a pH of 12.5 to 13.5. Most cases of deep ulceration going on to stricture formation involve lye solutions of pH 14. The critical pH that causes esophageal ulceration is 12.5, and thus a patient ingesting a substance with a pH greater than 12 should be followed closely for the possibility of esophageal ulceration.
Bibliographical noteFunding Information:
From the Department of Emergency Medicine, Hennepin .County Medical Center,* and the University of Minnesota College of Pharmacy,f Minneapolis, Minnesota. Presented at the University Association for Emergency Medicine Annual Meeting, Orlando, Florida, May 1979. This study was supported in part by PHS Grant 1416043690A3. Address for reprints: Joseph E. Clinton, MD, Department of Emergency Medicine, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, Minnesota 55415.
- burns, chemical caustics
- ingestion, caustics
- toxicity, alkaline