In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the January 2025 Emergency Medicine Practice article, Alkali Exposure: An Evidence-Based Approach to Diagnosis and Treatment
- Patient Demographics and Case Scenarios:
- Types of patients prone to alkali exposure
- Causes and scenarios leading to alkali exposure (e.g., accidental, intentional, social media challenges)
- Poison control reports and statistics
- Types and Effects of Exposure:
- Different types of exposure: ingestion, ocular, dermal
- Effects of ingestion, particularly in children and young adults
- Pre-hospital Care and First Response:
- Importance of decontamination
- Safety measures for EMS personnel
- Steps to take in pre-hospital care
- History and Physical Examination:
- Key points to focus on during history taking
- Important signs and symptoms to check
- Laboratory and Diagnostic Testing:
- Overview of useful lab tests and imaging
- Role of EKG and chest x-ray
- Importance of early consultation with poison control
- Endoscopy and CT Imaging:
- Use of endoscopy to classify injuries and guide treatment
- Role of CT imaging
- Complementary use of endoscopy and CT
- Treatment Approaches:
- Initial resuscitation and airway management
- Use of steroids and other medications like antibiotics, H2 antagonists, and topical mitomycin C
- When and how to use NG tubes
- Special Populations and Long-term Considerations:
- Special considerations for children
- Risks associated with laundry detergent pods
- Long-term complications, including strictures and increased risk of esophageal cancer
- Conclusion:
- Summary of major points discussed
- Reminder for continued vigilance and the importance of early consultation
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Sam Ashoo, MD, FACEP, is board certified in emergency medicine and clinical informatics. He serves as EB Medicine’s editor-in-chief of interactive clinical pathways and FOAMEd blog, and host of EB Medicine’s EMplify podcast. Follow him below for more…
