Laundry gels, detergents, disinfectants and other daily necessities that are often prepared at home, if they are not careful, may become the "killer" of children's health.
In the past 2 weeks, the emergency department of Zhejiang University Children's Hospital has received 3 children injured due to the accidental ingestion of corrosive agents, of which 2 have entered the ICU, of which 1 is particularly seriously injured, and the lips, mouth, pharynx and larynx have been corroded, and their condition was critical for a time.
One after another of these safety incidents has attracted the attention of emergency department doctors. Wu Xiujing, director of the emergency department, reminded that most of the many washing cleaning supplies that are often prepared at home have certain corrosiveness, especially those that look like soft candy candy, and parents should especially keep it properly, in case they are mistakenly taken by children, the consequences will be unimaginable.
The 1 year and 4 months old baby entered the ICU
Just because I ate a packet of white powder
1 year old and 4 months old Xuanxuan, cute and very cute, the mother did not dream that the daughter who has been healthy and lively will live in the ICU, the cause is to eat the pipe dredging agent that is often prepared at home. When the family found out, she was already crying in the bathroom, coughing from time to time, with a little bleeding in her lips, holding a package of dismantled pipe unclogging agent in her hand, and there was scattered white powder on the ground, and the family rushed her to the hospital.
After Xuanxuan finished emergency treatment in the emergency department, she was sent to PICU and put on a ventilator. Fortunately, the medical treatment was sent in time, and there was not much to eat, Xuanxuan successfully withdrew after three days, and there was no longer a worry about her life.
The 1-year-old and 8-month-old baby entered the ICU
Only because a pack of caustic soda tablets was opened
1 year and 8 months of brilliance, walking more and more steadily, lively and active, he runs to the toilet from time to time, curiously touching here and there. What the family did not expect was that he actually turned over a pack of caustic soda tablets placed in the toilet cabinet, and successfully opened it, poured the caustic soda tablets into his mouth and ate it.
After the family found out, they quickly took it off, and then tried to rinse him with water, but the wound in the mouth was more serious (this action is dangerous, strong alkali meets water and heat, which will cause a large area of burns to the oral mucosa). The family rushed him to the emergency department of Zhejiang University Children's Hospital, and the doctor found that his lips, mouth, and throat were very swollen and he was worried about his life, and after the emergency department was intubated, he was immediately sent to PICU. Cancan became the most seriously injured of these children, and has been living in the custody room for more than ten days, and has not yet been out of danger.
In 3 years, 39 children who mistakenly took corrosive agents were admitted
Nearly 50,000 children aged 0-14 die each year in China, an average of more than 130 per day, and according to the Chinese Center for Disease Control and Prevention, child unintentional injuries in mainland China account for 26.1% of all child deaths. In the past two weeks, the emergency department of Zhejiang University Children's Hospital has continuously received 3 children who mistakenly took corrosive agents, of which 2 children were admitted to PICU rescue and supervision.
To this end, the emergency department of Zhejiang University Pediatric Hospital reviewed a total of 39 cases of children who had mistakenly taken corrosive agents in the past 3 years, including 21 cases of boys and 18 cases of girls; the age distribution was as small as 4 months and 23 days, the maximum age was 7 years and 5 months, mostly in the age group of 1 year to 2 years, a total of 22 cases; 7 cases in the age group of 2 years to 3 years old, and a total of 10 cases in the remaining age group.
The most common cases of accidentally taking corrosive agents are 16 cases of pipe unclogging agents, 6 cases of caustic soda, industrial alkali, 4 cases of laundry gel beads, and others include hydrofluoric acid, potassium permanganate, sulfuric acid, various cleaning agents such as color bleaching powder, dirt cleaner, dust cleaner, automobile engine oil cleaning agent, and hair dye.
Which children are most likely to mistakenly take corrosive agents?
Statistically, misuse of corrosive agents is most common in infants and young children aged 1-3 years. Because children of this age are very curious, have learned to climb and walk, but lack of safety awareness, lack of necessary judgment, grab items and eat them in their mouths; the consumption of modern household cleaning products is increasing, various pipe dredgers and kitchen and bathroom cleaners, usually liquid, powdery or granular; concentrated clothing or dishwasher detergents, especially disposable small packaging products (capsules, gel bags or beads) are more and more common, such products are usually small in size and brightly colored, Similar in appearance to candy, children can easily mistake it for candy to eat in their mouths; therefore, it is particularly important to strengthen the safety risk education of parents and caregivers.
Is it dangerous and serious for children to mistakenly take corrosive agents?
What is a corrosive agent? The so-called corrosive agent is a substance that can burn or corrode the body's tissues through chemical action. Acidic and alkaline corrosives are two common types of corrosive agents. Most of the corrosive agents often ingested by children are household cleaning products, including household bleach or stove and pipe cleaners, most of which are strong bases containing sodium hydroxide and potassium hydroxide; other common cleaning products include clothing detergents containing sodium phosphate, sodium carbonate and ammonia, dishwasher detergents and detergents; and corrosive agents that may be ingested include beauty products (such as hair straightening cream), swimming pool products and toilet cleansers. According to statistics, clinically, the intake of alkaline substances in children is more common than the intake of acids.
What are the consequences of my child's intake of corrosive agents?
After ingestion of caustic agents, corrosive injuries of the lips, mouth, pharynx and larynx, corrosive esophagitis, corrosive gastritis, esophageal ulcer formation, inhalation pneumonia, etc. can occur in severe cases, esophageal stenosis, esophageal perforation, tracheoesophageal fistula, vocal cord paralysis, aortic arch perforation, mediastinitis, spinal discitis, gastric bleeding and perforation, intestinal perforation, and even death.
The incidence of esophageal stenosis after ingestion of alkaline corrosive agents is 47% to 90%, and the incidence of esophageal stenosis after ingestion of acidic corrosive agents is 6.5% to 50.0%. The literature reports that children may have gastrointestinal tumors 15 to 40 years after ingestion of corrosive agents, and the incidence of gastrointestinal tumors in children who have had corrosive damage to the digestive tract is 3,000 times higher than that of those who have not ingested corrosive agents.
Endoscopy is the gold standard for assessing the extent of gastrointestinal injury and, if airway injury is combined, tracheoscopy is also required. After taking the caustic agent by mistake, the doctor should be seen in time, and the probability of esophageal perforation and esophageal stenosis increases significantly if the diagnosis is delayed. If concomitant esophageal stenosis, multiple hospitalizations are usually required for endoscopic esophageal stenosis dilation.
Are the consequences of taking different corrosive agents differently?
Depending on the nature, traits, concentration, amount of ingestion of the caustic agent, the time of contact between the caustic agent and the mucous membrane of the digestive tract, and whether the consultation is delayed, the susceptible organs and the degree of damage also vary. If the acidic corrosive agent is easy to damage the esophagus when the pH is lower than 2, the mechanism is coagulant necrosis, forming eschar, and it is relatively less likely to cause penetrating damage to the digestive tract such as perforation of the digestive tract. However, upper airway injury is more common when acidic substances are ingested.
If the pH of the alkaline corrosive agent is higher than 11.5-12.5, it is more likely to damage the esophagus of children, and its mechanism is mainly to cause liquefied necrosis. Such injuries can lead to rupture of the mucous membrane at an early stage and penetrate deep into the depths, easily forming perforations of the digestive tract, especially in physiologically narrowed areas. In children, because of the action of the thymus gland, the speed of corrosive agents through the esophagus is slowed down, so the exposure of the esophageal mucosa to corrosive agents is prolonged, and the upper 1/3 segment of the esophagus is more vulnerable. Powdered corrosive agents are more damaged than liquid corrosives, which are easy to cause local damage and easy to form perforations.
After taking the corrosive agent by mistake, how to judge whether it is serious?
After your child ingests a caustic agent, the clinical features vary widely. The most common symptoms after ingestion of corrosive agents are pain in the mouth, ulcers, salivation, vomiting and even vomiting blood. Mild diseases can manifest only as pain under the neck and retrosternal bone, congestion of the lips, gums, tongue, and pharynx; severe diseases may have a burning sensation in the lips, throat, severe pain behind the sternum or epigastric region, pallor, anxiety, salivation, fine pulse, shock, coma, or even death.
There have also been reports of children who have no symptoms after ingesting corrosive agents and who have been diagnosed with gastrointestinal stenosis due to vomiting and dysphagia. Symptoms suggestive of upper airway injury include stridor, hoarseness, nasal flapping, and triangular signs. Powdered or granular detergents can easily damage the upper airway. Epiglottitis injury should be considered when the symptoms described above occur, which can be very severe (especially for children under 2 years of age) and may require urgent intubation or tracheostomy.
In a study of 378 children who ingested caustic agents, 12% of patients were asymptomatic but had severe esophageal burns; the presence or absence of oral injury was not a good predictor of esophageal injury.
What should I do if I find that my child has mistakenly taken a corrosive agent?
Can it be diluted with water or milk?
1. Send the child to a hospital with treatment conditions such as children's endoscopy at the first time. Take care to prevent vomiting, suffocation and aspiration on the way.
2, it is best to bring the corrosive agent product or outer packaging or instructions.
3. It is forbidden to induce vomiting or gastric lavage therapy, because if vomiting causes gastric contents to contact the esophageal mucosa, it may cause additional esophageal damage.
4. The neutralizer cannot be used because of the fear that the heat released during the neutralization process will cause additional damage.
5. Thinners (such as milk or water) cannot be used because of safety concerns and lack of efficacy. The safety issue with taking thinners is that ingesting a lot of thinners can induce vomiting, which can lead to further complications. Acute airway swelling and obstruction are contraindications to diluents. (This is a mistake that parents are prone to make, which is especially alarming.)
6. For children who consume acidic or alkaline corrosive agents (such as sodium hydroxide or potassium hydroxide, or hydrochloric acid or sulfuric acid), activated charcoal is usually not used. Because activated carbon obscures the endoscopist's field of vision, activated carbon is not easy to adsorb highly ionized small molecule chemicals.
7. It is best to inform the emergency department doctor in detail and accurately about the type, intake, intake time, last feeding time and water intake time.
Accidental ingestion of corrosive agents is a serious threat to the health of children in both long and short terms, so as a parent or a child's caregiver, how to avoid such accidents?
1, a large number of detergent can not be placed at home, especially in the kitchen.
2. Chemicals stored in the home such as caustic soda tablets, sulfuric acid, etc. should be placed on the locked cabinet and the upper shelf, and put back in place immediately after use.
3. If some chemical materials are kept in a labeled container, and kept tightly sealed.
4) Parents should avoid storing these chemicals in everyday, unlabeled beverage bottles, especially in containers known to store edible substances.
5. Do not place any household cleaners or detergents in places where children can reach.
6. Children, especially young children under the age of 5, must not be placed in any space or environment where there is an unexpected risk.
Orange Persimmon Interactive City Express reporter Yu Xixi
Correspondent Zhu Yaoling