Here in Britain, home cleaning products are incredibly vague when it comes to their ingredients. For example, my toilet cleaner lists its ingredients as “Less than 5% non-ionic surfactants, cationic surfactants, perfume, Disenfectant.” How do hospitals deal with poisonings resulting from people ingesting these products? Is it enough to tell the doctor, say, “I swallowed cationic surfactants”, because the treatment for ingestion of all such surfactants is the same? I rather suspect this isn’t usually the case—take the ingredient “disinfectant” in my toilet cleaner. Disinfectants encompass a pretty broad range of chemicals—ethyl alcohol, formaldehyde, and phenol are all disinfectants, but I find it hard to believe that the same treatment is used for ingestion of each.
So given only the bottle of the cleaner swallowed, how is the doctor supposed to know what treatments or antidotes to administer? Are the cleaning product companies required to register detailed ingredient lists with hospitals (or some centralized poison control database which medical practitioners can access)? Or are the poisoning victims pretty much out of luck? “Well, Mr. Smith, we’d like to treat your two-year old son for swallowing that bottle of Drainonex, but as the company considers its ingredients to be a trade secret, I’m afraid we have no idea which antidote to administer. We don’t want to guess, as administering the wrong one could actually worsen the situation. So we’ll just wait around for a few hours and hope he doesn’t die.”
I could be misremembering, as it’s been nearly ten years since I lived in North America, but it seem to recall that cleaning products there actually indicated the specific chemicals they contained. Can anyone confirm whether this is or was the case?
I would imagine if you’ve swallowed any type of cleaning product, the main thing they would do is pump your stomach and try to get you to purge it before any more of it is absorbed into your system. They might also get you to swallow something that absorbs the toxins, like charcoal. I’m not sure how much they can do if something is already in your system, but hopefully someone with medical training can enlighten us. I know the general type of cleaner (bleach, ammonia, etc) is more important than individual ingredients, and emergency personnel on the scene (in the US at least) will try to ascertain the general type of cleaning product you’ve swallowed.
And yeah, here in the US cleaning products are required to have ingredients listed on the container, and I’ve seen many workplaces that have spots where you can look up information on the chemicals used there.
I am by no means an expert, but I have always been under the impression that they only need to specifically need to list information that would make a difference to the mode of treatment. Anything sold for general household use has to be tested/approved as being relatively non-lethal, so usually they shouldn’t have anything dangerous enough to worry about - if there is, it is flagged.
A fairly generic strong cleaner is going to have a lot of detergents, some sort of disinfectant, and some smelly stuff, e.g linalool or limonene - I would imagine most of these could be treated the same whether it is for floor cleaner or toilet cleaner. Most shampoos/showergels are weak detergents plus perfumes and would be treated in another way, etc. If there is something unusual or extra dangerous that requires special treatment, it has to be called out on the label. This would be stuff like oven cleaner, bleach, paint stripper/thinner, etc.
E.g.
corrosive - means do not induce vomiting unless you are a real expert
strong petrochemicals - likewise
Acid - corrosive, neutralize with mild alkali
Alkaline - corrosive, neutralize with mild acid
Specific poisons - treat with appropriate specific antidote
General treatment if no special warnings - make 'em puke and/or pump stomach, feed them something absorbent/neutralising (activated charcoal, milk, etc), keep a close eye on them for a few days.
Did you read my OP? How is the American Association of Posion Control Centres going to help identify the best treatment for someone who has swallowed one of these British cleaning products which don’t indicate their ingredients? Are British manufacturers obliged to inform the American poison control centres which chemicals they use?
I don’t know about you, but no home cleaning product I’ve ever purchased has come with or referred to the existence of a material safety data sheet. Even if I had a material safety data sheet for every known chemical, it wouldn’t help me if the cleaning product didn’t indicate which chemicals it contained.
Your OP isn’t really clear about what your question is.
Are you asking how an American hospital would treat somebody poisoned by an American product? How a British hospital would treat somebody poisoned by a British product? Or how an American hospital would treat somebody poisoned by a British product?
The MSD sheets go to employers. However, you get one for each product (not for the individual chemicals), and they do tell you what to do in case of poisoning or over-exposure to a particular product. The company that sells the product mails it to your company or institution separately, whether you ask for it or not.
There’s a direct number at the top of the web page to call 24/7/365. Unfortunately, the site fails UK accessibility because when the images are disabled that number cannot be easily found located. Bad form if your Internet connection is flakey, you have someone suspected of being poisoned and you are freaking out. Probably better to attached that number to every phone in the house right now.
They are available. Theoretically I should be able to request one from the store that sells the product, but certainly manufacturers must provide them.
My question is, if a patient presents himself at the hospital (I don’t care if it’s American or British) with one of these British bottles and claims to have swallowed the contents, what does the hospital do to determine how he should be treated? Is the information on the bottle sufficient, or is there some other source of information about the product which the hospital is able to consult?
I suppose others have answered the question more or less satisfactorily here: yes, the information on the bottle is probably sufficient, since the treatment is going to be more or less the same no matter what (i.e., empty the stomach if possible, and introduce charcoal); if further information is needed, perhaps there is some database of MSDS’s to which manufacturers are required to contribute more detailed information on the contents of their products; a hospital (at least, a British one) would presumably know where to look for these sheets.
American products are required to provide MSDS to central databases. A hospital can contact them and get whatever information they need about the product’s contents and treatment for it.
I don’t know if the UK has a similar system in place.
A WAG but I suppose if somebody showed up a hospital having swallowed some foreign product which didn’t specifically list its ingredients, the hospital staff would probably treat it like they’d treat the analogous local product. The ingredients in British and American toilet cleaners are probably pretty similar.
Depends on what you swallowed. Some things would do more damage coming back up than if you left them in place. The stomach, after all, is normally full of corrosive acid which it usually contains pretty well, and if what’s been swallowed is alkaline stomach acid might help neutralize it. Now, after it’s neutralized, or absorbed by activated charcoal, then they might do the stomach pump thing.
Something that causes chemical burns might not be absorbed well as all, depending on the tissue destruction. The burned, dead flesh might act somewhat as a barrier.
As the typical urban ER sees its share of suicide attempts and accidental poisonings an ER doctor might well have prior experience in treating these sorts of problems. If the general category of chemical(s) can be identified I’d guess treatment can at least start and based on how the patient does can be tweaked going forward.
I will say, however, that cleaning products here in the US usually list active ingredients (the ones that can cause poisoning) and frequently also emergency first aid instructions. Some products, such as Draino drain cleaner, are used frequently enough for self harm that just knowing the name will probably let the doctor know what he or she is dealing with and how to proceed.
Poison control centers have a pretty good database of products and a pretty good idea of what general compounds are involved in various classes of products.
Immediate management is usually centered around whether or not (and how) to empty the stomach, whether or not to administer diluents and cathartics and so on, and whether or not induction of vomiting is advisable (usually not).
Most of the potentially toxic products I see at least address baseline severe poisons and whether or not vomiting is advised (again, usually not).
There are surprisingly few household-type poisonings that need very specific management (antidote-level “I gotta know the exact chemical”) for the particular chemicals ingested. It’s usually enough to know that it’s a strong base (drain cleaner) or bleach, or whatever. A handful of industrial poisonings fall into that category, and medication excess doses do as well. But ordinary stuff hanging around the house generally has enough information on the label for the poison control center to dope out what approach to take.