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Trisodium phosphate poisoning

Trisodium phosphate is a strong chemical. Poisoning occurs if you accidentally swallow, breathe in, or spill large amounts of this substance on your skin.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or a local poison control center at 1-800-222-1222.

Alternative Names

Sodium orthophosphate poisoning; Trisodium orthophosphate poisoning

Poisonous Ingredient

Trisodium phosphate

Where Found

  • Some automatic dishwashing soaps
  • Some toilet bowl cleaners
  • Many industrial solvents and cleaners (hundreds to thousands of construction agents, flooring strippers, brick cleaners, cements, and many others)

Note: This list may not be all-inclusive.

Symptoms

Airways and lungs

  • Breathing difficulty (from inhalation)
  • Coughing
  • Throat swelling (which may also cause breathing difficulty)

Esophagus, stomach and intestines

  • Blood in the stool
  • Burns of the esophagus (food pipe) and stomach
  • Diarrhea
  • Severe abdominal pain
  • Vomiting, possibly bloody

Eyes, ears, nose, and throat

  • Drooling
  • Severe pain in the throat
  • Severe pain or burning in the nose, eyes, ears, lips, or tongue
  • Vision loss

Heart and blood

  • Low blood pressure -- develops rapidly
  • Collapse
  • Severe change in blood acid level
  • Shock

Skin

  • Burns
  • Hives
  • Holes in the skin or underlying tissue
  • Skin irritation

Home Care

Do NOT make a person throw up.

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 patient is vomiting or has a decreased level of alertness.

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

Before Calling Emergency

Determine the following information:

  • The patient's age, weight, and condition
  • The name of the product (ingredients and strengths, if known)
  • The time it was swallowed
  • The amount swallowed

Poison Control

In the United States, call 1-800-222-1222 to speak with a local poison control center. This hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. 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.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to Expect at the Emergency Room

Treatment depends on how the poisoning occurred. The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. Pain medicines will be given.

For swallowed poison, the patient may receive:

  • Endoscopy -- camera down the throat to see burns in the esophagus and the stomach
  • Fluids by IV

For inhaled poisons, the patient may receive:

  • Breathing support, possibly a breathing tube
  • Bronchoscopy -- camera down the throat to see burns in the airways and lungs
  • Chest x-ray
  • Intravenous fluids (fluids through the vein)
  • Oxygen

For skin exposure, the patient may receive:

  • Skin debridement (surgical removal of burned skin)
  • Washing of the skin (irrigation) -- perhaps every few hours for several days

Outlook (Prognosis)

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

Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible. The ultimate outcome depends on the extent of this damage. Damage continues to occur to the esophagus and stomach for several weeks after the poison was swallowed, and death may occur as long as a month later.

Prevention

Keep all poisons in their original and/or childproof container, with labels visible, and out of the reach of children.

References

Wax PM, Young A. Caustics. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2013:chap 153.

Updated: 10/11/2013

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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