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First Aid for Nitric Acid Poisoning

Last updated March 2, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Nitric acid is a very strong acid that has the potential to cause very serious burns through its corrosive action. Nitric Acid Poisoning is the accidental or intentional intake of nitric acid, or any product containing the compound. The exposure may be through skin/eye contact, or following ingestion of the chemical.

What is Nitric Acid Poisoning?

  • Nitric acid is a very strong acid that has the potential to cause very serious burns through its corrosive action
  • The acid is used in the manufacture of rocket propellants, fertilizers, textiles, lab reagents, plastics, industrial catalysts, cleaning and etching agents, etc. 
  • Nitric Acid Poisoning is the accidental or intentional intake of nitric acid, or any product containing the compound. The exposure may be through skin/eye contact, or following ingestion of the chemical
  • The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Nitric Acid Poisoning may be also referred to variously as the following:

  • Acidum Nitricum Poisoning
  • Aqua Fortis Poisoning
  • Eau Forte Poisoning
  • Hydrogen Nitrate Poisoning
  • Nitric Acid Toxicity
  • Spirit of Niter Poisoning

What are the Causes of Nitric Acid Poisoning?

  • Nitric Acid Poisoning is caused by the ingestion of nitric acid (liquid). The exposure may also be through direct skin or eye contact
  • Inhalation of the corrosive nitric acid vapors may lead to respiratory problems
  • This intake could be accidental, or in some cases intentional, to bring self-harm

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Nitric Acid Poisoning?

The signs and symptoms can vary from one individual to another. It may be mild in some and severe in others, depending on the level of concentration of the acid and the amount swallowed or inhaled. The signs and symptoms of Nitric Acid Poisoning may include:

When swallowed, the signs and symptoms may include:

  • Severe burning and associated pain in the mouth, throat, and food-pipe
  • Drooling from the mouth
  • Loss of vision; unable to speak or swallow
  • Inflammation of the throat may cause respiratory difficulties
  • Sudden reduction in blood pressure (hypotension) resulting in shock
  • Vomiting blood
  • Fever

On skin contact, the signs and symptoms may include:

  • Severe skin and tissue burns associated with pain
  • Severe eye burns associated with pain; loss of vision

When inhaled, the signs and symptoms may include:

  • Coughing (including coughing-up blood), choking
  • Heaviness in the chest; chest pain
  • Bluish discoloration of lips and beneath fingernails
  • Respiratory difficulties
  • Reduced blood pressure (hypotension)
  • Increased heart-rate
  • Feeling dizzy and weak
  • Collapse

How is First Aid administered for Nitric Acid Poisoning?

First Aid tips for Nitric Acid Poisoning:

  • Call 911 or your local emergency help number immediately, for emergency assistance
  • Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
  • Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
  • Carefully remove the individual from the exposure area
  • Confirm that the airways are protected; also, ensure breathing and the presence of pulse
  • If skin exposure or involvement of the eye has occurred, then wash thoroughly with copious amounts of water (for at least 15 minutes)
  • Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
  • Following an ingestion of the substance, immediately give water or milk to drink (if instructed by the healthcare professional). If available, administer milk of magnesia (120-180 ml or 4-6 oz)
  • In case of symptoms that indicate difficulty in swallowing including vomiting or decreased alertness, do not give anything by way of mouth
  • Take individual to emergency room (ER) for further treatment
  • Always try to take the compound bottle/container to the ER

The emergency medical health professional might perform the following steps towards treating the condition:

  • Monitor vital signs
  • Medically manage symptoms and provide breathing support, if necessary
  • Wash skin and eyes repeatedly and thoroughly (irrigation), to eliminate any remaining hazardous compound
  • Administer fluids by an intravenous drip line
  • Surgical procedures to repair damaged areas and restore tissue and skin

Who should administer First Aid for Nitric Acid Poisoning?

First aid for Nitric Acid Poisoning is administered by healthcare professionals.

  • The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
  • They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Nitric Acid Poisoning?

  • The prognosis of Nitric Acid Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient
  • In most cases, the outcome is dependent upon the nature of the acid (whether dilute or concentrated), rapid or delayed treatment response, and severity of the injury/burns
  • The prognosis can only be assessed on a case-by-case basis. In case of severe symptoms including severe burns and organ damage, it may considerably worsen the outcome
  • Ingesting nitric acid can result in long-term damage to the mouth, food-pipe, and stomach; the chemical has the potential to continue causing damage to the affected region, even after exposure is ceased
  • Inhaling nitric acid vapors can seriously injure the airways and lungs. The injuries may be irreversible and deaths are known to occur

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Nitric Acid Poisoning be Prevented?

Nitric Acid Poisoning can be prevented by:

  • Always following instructions for usage of any chemical product
  • Keeping any poisonous/hazardous chemicals and other materials out of children’s reach
  • Keep all poisons correctly labeled and in suitable storage locations
  • Wearing appropriate protective wear when working with such chemicals
  • Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

What are certain Crucial Steps to be followed?

  • Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
  • Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
  • It would be helpful if the following information is readily available:
    • Type, amount and time of consumption of the substance
    • Age and weight of the individual
    • And, the overall health status of the individual

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 3, 2017
Last updated: March 2, 2018