Treatment for Harpic (Bleach) Ingestion
In case of Harpic (bleach) ingestion, immediately irrigate the affected area with copious amounts of water and do not administer anything by mouth unless advised by poison control center or emergency medical personnel. 1
Immediate Management
- Do not induce vomiting as this can increase the risk of pulmonary complications through aspiration and cause further damage to the esophagus 2
- Do not administer activated charcoal as it is not recommended for caustic substance ingestions and may cause additional harm 3
- Do not administer syrup of ipecac for ingestion of toxins 1, 3
- Contact poison control center or emergency medical services immediately for guidance 3
Medical Interventions
- Protect the airway as chemical pneumonitis is a significant risk due to potential inhalation of fumes or aspiration during vomiting 2
- Assess for signs of respiratory distress such as stridor, which may indicate airway injury requiring urgent intervention 2
- Monitor for signs of aerodigestive tract injury including hypersalivation and dysphagia, which may indicate the need for endoscopic evaluation 4
- Provide aggressive intravenous fluid therapy to manage metabolic imbalances and prevent dehydration 5
Hospital Management
- Endoscopic evaluation may be necessary to determine the extent of injury, particularly if the patient presents with hypersalivation and dysphagia 4
- Imaging studies such as computed tomography may help define the extent of injury to the gastrointestinal tract 6
- Medical management may include bowel rest, antibiotics, and proton pump inhibitors depending on the severity of injury 6
- Surgical intervention may be required in cases of perforation or severe injury 6, 5
Important Cautions
- Blind insertion of a nasogastric tube is contraindicated due to the risk of perforation and potential to induce regurgitation or vomiting 2
- Neutralization attempts with weak bases are not recommended as they can produce excessive heat and worsen tissue damage 7
- Dilution with water should be done cautiously as it can also generate heat when mixed with strong acids 7
Long-term Considerations
- Monitor for late complications such as stricture formation, particularly pyloric stricture which is common after acid ingestion 5
- Follow-up endoscopy may be needed to assess healing and detect early signs of stricture formation 4
Special Considerations for Bleach (Sodium Hypochlorite)
- For household bleach ingestion specifically, dilution with water may be appropriate as the primary intervention, unlike with strong mineral acids 8
- Ensure the bathroom or treatment area is well-ventilated to prevent inhalation of toxic fumes 9
- Never mix bleach with other household cleaning products, especially those containing ammonia, as this can create toxic gases 9