title: Evidence-Based Management Of Caustic Exposures In The Emergency Department.
abstract: Caustics are common in household and industrial products, and, when ingested, they can pose a significant public health risk. Caustic exposures in adults typically present in the setting of occupational exposure or suicide attempt; exposures in children occur most often by unintentional ingestion. Caustics cause local damage upon contact with tissue surfaces and can lead to systemic toxicity. Endoscopy is recommended in all intentional ingestions (and many unintentional ingestions) to grade injury severity, determine treatment options, and assess prognosis; however, it is generally best performed within 24 hours post ingestion to avoid risk of perforation. Radiography and computed tomography may also be used to visualize injury in certain cases. This review examines the pathophysiology of caustic exposures, their clinical presentations, and the most current evidence on recommendations for decontamination, surgical consult, treatment, and disposition.
authors.affiliation: Medical Toxicology Fellow, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY.
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Wightman
authors.affiliation: Assistant Curator, New York University Health Sciences Library, New York University School of Medicine, New York, NY.
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Read
authors.affiliation: Professor of Emergency Medicine and Medicine, Director of the Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hoffman
mesh_terms: D000328:Adult; D002057:Burns, Chemical / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D002424:Caustics / Q000633:toxicity*; D002675:Child, Preschool; D019091:Critical Pathways; D003937:Diagnosis, Differential; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D004947:Esophagus / Q000293:injuries*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D002424:Caustics