Laundry Detergent Capsule Exposure

From IAEM - Laundry Detergent Capsule Exposure Guideline.



Background

Laundry Detergent capsules (e.g. Liquitabs) are household domestic products usually packaged as small, brightly coloured concentrated detergent sachets. The majority of laundry detergent capsules contain a combination of agents, of which include, an anionic detergent (20-30%), a non ionic detergent, propylene glycol (15 – 20%), and ethanol (2 – 5%) and a cationic surfactant. These agents are dissolved in water to form an alkaline solution.

Most patients are < 5 years old and present with ingestion, eye contact or skin contact symptoms.

Serious oesophageal ulceration may occur.


Symptoms

  • GI: Vomiting, nausea, dairrhoea and less comonly abdominal pain
  • Airway: Coughing, Bronchospasm, Pharyngitis, stridor
  • Chemical burn

Management

  • Detailed Hx/Exam
  • Beware symptoms above
    • If epiglottic burn - call anaesthetics
    • Mouth burns indicate a risk of imminent airway compromise
    • If well but risk of airway burn/oedema:
      • CXR and PFA
      • Analgesia and supportive management
  • Surgical assessment ± early endoscopy/ CT
  • Give broad-spectrum antibiotics if proven perforation
  • IV H2 antagonists or PPIs may reduce corrosive injury
  • Activated charcoal is contraindicated
  • Gastric lavage is not recommended
  • Immediate lavage and ophthalmology referral if suspected (alkali) eye injury

Admission/observation

Involve anaesthetics (airway) or surgical(GI) with findings above.


GCS of 15, no obvious burns/symptoms

  • Observe for 6 hours and monitor vitals
  • ECG to assess QRS and QT intervals
  • Repeat ECGs is patients are symptomatic

In patient with GCS of less than 15

  • FBC, U&E, Coag and VBG
  • 12 lead ECG
  • Complete primary and secondary assessment


Content By Dr Éanna Mc Suibhne, Dr Íomhar O' Sullivan 02/11/2018. Last review Dr ÍOS 16/06/21.