Alkali Exposure

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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