What is Sodium Bisulfate Poisoning?

• Sodium bisulfate is a white granular sodium salt that is used in swimming pools for decreasing pH value of water, to ensure better chlorination. It is also used in various fungicides, herbicides, domestic cleaners, and in providing metal finishes
• Sodium Bisulfate Poisoning is the accidental or intentional intake of products containing sodium bisulfate
• 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)

Sodium Bisulfate Poisoning may be also referred to as the following:

• Bisulfate of Soda Poisoning
• Sodium Acid Sulfate Poisoning
• Sodium Bisulfate Toxicity
• Sodium Hydrogen Sulfate Poisoning

What are the Causes of Sodium Bisulfate Poisoning?

• Sodium Bisulfate Poisoning is caused by the intake of sodium bisulfate compounds. The exposure may also occur following skin or eye contact, or the compound may be inhaled
• This intake could be accidental, or in some cases intentional, to bring self-harm
• Sodium bisulfate is classified as an acutely toxic substance with potential to cause severe damage upon exposure/ingestion 

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 Sodium Bisulfate Poisoning?

The signs and symptoms of Sodium Bisulfate Poisoning can vary from one individual to another. It may be mild in some and severe in others. Several systems of the body, such as the respiratory system, digestive system, skin and ENT, may be affected

The signs and symptoms of Sodium Bisulfate Poisoning may include

• Burning and pain in the throat and food-pipe; it may also involve the ears, eyes, nose, and mouth (lips, tongue)
• Severe respiratory difficulties and chest pain, due to burns in the throat and food-pipe
• Swelling of the mouth and tongue; unable to speak clearly
• Drooling from the mouth
• Feeling of choking/gagging, coughing
• Fluid formation in the lungs
• Severely decreased blood pressure, which can result in giddiness and shock
• Severe skin burns with blister formation
• If the eye is exposed to the compound, it can result in eye irritation, redness, and watering
• Decrease in vision
• Nausea, vomiting (blood in vomit)
• Diarrhea

How is First Aid administered for Sodium Bisulfate Poisoning?

First Aid tips for Sodium Bisulfate Poisoning:

• Call 911 or your local emergency help number 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; move them to region of fresh air immediately
• Confirm that the airways are protected; also, ensure breathing and the presence of pulse
• Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
• Clean the mouth to remove any remaining compound; wipe mouth with a wet cloth
• Following an ingestion of the substance, immediately give milk to drink
• In case of symptoms that indicate difficulty in swallowing including vomiting or decreased alertness, do not give anything by way of mouth
• If eye exposure has occurred, then wash the eye thoroughly with copious amounts of water (for about 15 minutes)
• 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:

• Medically manage symptoms and provide breathing support, if necessary
• Administer suitable medication to neutralize the swallowed compound
• Wash skin and eyes repeatedly and thoroughly (irrigation), to eliminate any remaining hazardous compound; use soap and water
• Following this, a suitable skin or eye ointment may be used to treat the exposure
• Surgical treatment for skin burns including removal of burnt skin
• Administer fluids by an intravenous drip line

Note: In severe cases, surgical removal and repair of the affected portions of the gastrointestinal tract and stomach may be necessary.

Who should administer First Aid for Sodium Bisulfate Poisoning?

First aid for Sodium Bisulfate 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 Sodium Bisulfate Poisoning?

• The prognosis of Sodium Bisulfate 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
• If the individual can recover from the symptoms, with appropriate medication and prompt support, the outcome is better
• Treatment delays may lead to complications including perforation of the throat, food-pipe, or gastrointestinal tract. Due to this, bleeding and infection can additionally worsen the prognosis. In some individuals, damage to the internal organs may continue to take place for many weeks and even months after the poisoning incident
• In case of severe poisoning, there is a chance of lung damage that may be severe. Damage to the brain may become irreversible, if timely oxygen therapy is not administered. Deaths have been reported from Sodium Bisulfate Poisoning

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 Sodium Bisulfate Poisoning be Prevented?

Sodium Bisulfate Poisoning can be prevented by:

• Wearing personal protective equipment (PPE) is useful in protecting the lungs, eyes, mucous membranes, and skin
• Keeping any poisonous/hazardous chemicals and other materials out of children’s reach
• Ensure that industrial safety regulations for compound exposure is adhered to at workplaces
• Keep all poisons correctly labeled and in suitable storage locations
• 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