Recommended Dose of Polyethylene Glycol (PEG) for Phenol Poisoning Treatment
For phenol skin decontamination, undiluted polyethylene glycol (PEG 400) should be immediately applied to the affected area, followed by thorough washing with soap and water. 1
Immediate Skin Decontamination Protocol for Phenol Exposure
- Immediately remove contaminated clothing and isolate the affected area 1
- Apply undiluted polyethylene glycol (PEG 400) directly to the affected skin area 1
- After PEG application, thoroughly wash the area with soap and water 1
- For large surface area burns (>5% total body surface area), consider alternating 1-minute PEG applications with 1-minute water washes for a total of 15 minutes 2
Evidence Supporting PEG for Phenol Decontamination
- PEG 400 has been shown to be superior to water alone in reducing phenol-induced skin damage in controlled studies 2
- PEG application significantly reduces phenol absorption through the skin compared to no treatment 2
- PEG is particularly effective because it solubilizes phenol, facilitating its removal from tissues before systemic absorption can occur 3
- A patient with 20.5% total body surface area phenol burns and high serum concentrations (17,400 μg/L) survived after immediate and repeated treatment with PEG and silver sulphadiazine 3
Alternative Decontamination Options
- 70% isopropyl alcohol (IPA) has shown similar efficacy to PEG 400 in reducing phenol-induced skin damage 2, 4
- A mixture of PEG 300/industrial methylated spirits (2:1 by volume) has also demonstrated effectiveness in reducing mortality and systemic effects from phenol exposure 5
- Water washing alone is less effective than PEG or alcohol-based solutions for phenol decontamination 2, 4
Important Considerations and Precautions
- Health personnel should use protective gowns and rubber gloves when treating phenol exposures 1
- Avoid using ethanol or mineral oil for oral phenol ingestion as they may increase absorption 1
- For eye exposure to phenol, immediately irrigate with copious amounts of tepid water for at least 15 minutes 1
- For significant phenol ingestion (>1g for adults or >50mg for infants), immediate medical evaluation is required 1
- Monitor for systemic manifestations which may develop within 5-30 minutes post-exposure, including hypotension, dysrhythmias, seizures, acidosis, and methemoglobinemia 1