Treatment for Phenol Poisoning
The immediate treatment for phenol poisoning requires calling emergency services or poison control center (800-222-1222) while simultaneously initiating decontamination with polyethylene glycol (PEG), followed by thorough washing with soap and water. 1
Initial Management
- Contact poison control center (800-222-1222) or emergency services immediately upon suspicion of phenol exposure 2, 1
- Remove all contaminated clothing and jewelry to prevent continued exposure while avoiding self-contamination 1
- For dermal exposure, immediately decontaminate the skin with polyethylene glycol (PEG), followed by thorough washing with soap and water 1, 3
- Do not administer anything by mouth for any poisoning ingestion unless advised by poison control center or emergency medical personnel 2
Route-Specific Management
Dermal Exposure
- Remove contaminated clothing immediately to prevent continued exposure 1, 3
- Apply polyethylene glycol (PEG) to affected areas as the preferred initial treatment 1, 3
- Follow with thorough washing with soap and water 3
- Note that dermal phenol exposure produces initially painless white patches that later turn erythematous and finally brown 3
Eye Exposure
- Flush eyes immediately with copious amounts of tepid water for at least 15 minutes 1, 3
- Follow-up examination using fluorescein stain for corneal abrasion is recommended 3
Ingestion
- Do not induce vomiting 3, 4
- Avoid administering alcohol or oral mineral oil as they may increase absorption 3
- Gastric lavage is generally not recommended 3
- Consider immediate administration of olive oil and activated charcoal by small bore nasogastric tube if advised by poison control center 3
- Do not administer activated charcoal unless advised by poison control center or emergency medical personnel 2, 5
Systemic Management
- Establish and maintain vital functions as the first priority 3
- Establish vascular access for medication administration 3
- For shock: administer fluids and consider vasopressors (dopamine) 3
- For arrhythmias: consider antiarrhythmic medications 3
- For seizures: administer benzodiazepines (diazepam) 3
- For respiratory distress: provide 100% oxygen; intubation and assisted ventilation may be necessary 3
- For metabolic acidosis: administer sodium bicarbonate 1-2 mEq/kg 3
- For methemoglobinemia (if >30% or respiratory distress present): administer methylene blue 1-2 mg/kg of 1% solution, slowly IV 3
Special Considerations
- Phenol is well absorbed through all routes of exposure (inhalation, dermal, ingestion) 3
- Systemic manifestations develop rapidly (5-30 minutes) after exposure 3
- Healthcare providers should use appropriate personal protective equipment (gowns and rubber gloves) when treating phenol poisoning to avoid self-contamination 3
- Lethal dose of phenol can be as little as 1 gram, with typical lethal dose between 3-30 grams 3
Monitoring and Follow-up
- Monitor vital signs, cardiac rhythm, respiratory status, and neurological function 3
- Watch for signs of systemic toxicity: nausea, vomiting, lethargy, hypotension, tachycardia or bradycardia, dysrhythmias, seizures, acidosis, hemolysis, methemoglobinemia, and shock 3
- Patients with significant exposure should be monitored in a healthcare setting until symptoms resolve 3