What is Trisodium Phosphate Poisoning?

• Trisodium phosphate (TSP) is an organic compound that is present as a white crystalline solid at room temperature. It is described as a strong compound that mixes in large quantities with water
• Trisodium phosphate finds usage in commercial and domestic use products such as stain removers, cleaning agents (toilet cleaners), dishwashing soaps, food additives, and industrial solvents
• Trisodium Phosphate Poisoning is the accidental or intentional intake of products containing TSP
• 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)

Trisodium Phosphate Poisoning may be also referred to variously as the following:

• Sodium Orthophosphate Poisoning
• Sodium Phosphate Tribasic Poisoning
• Trisodium Orthophosphate Poisoning
• Trisodium Phosphate Toxicity
• TSP Poisoning

What are the Causes of Trisodium Phosphate Poisoning?

• Trisodium Phosphate Poisoning is caused by the ingestion/swallowing of trisodium phosphate chemical compounds
• Exposure of skin and eyes may result in injuries; inhalation of the fluid vapors may also result in symptoms
• This intake could be accidental, or in some cases intentional, to bring self-harm
• Trisodium phosphate compounds and products may include cleaning fluids, bleaches and disinfectants, soldering flux, food additives, and certain performance-enhancing nutritional supplements

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 Trisodium Phosphate Poisoning?

The signs and symptoms of Trisodium Phosphate Poisoning can vary from one individual to another. It may be mild in some and severe in others. Several systems of the body may be affected. The poisoning may occur due to swallowing of the compound, or breathing-in of trisodium phosphate fumes and vapors.

The signs and symptoms of Trisodium Phosphate Poisoning may include:

• Blood in vomit and/or stool; diarrhea
• Severe burning and associated pain in the mouth, throat, and food-pipe (even the stomach may be burnt); drooling from the mouth
• This may also affect the eyes, nose, and ears
• Speaking and swallowing difficulties due to swelling of tongue and throat
• Severe skin irritation and burns (perforations on the skin may be observed)
• Severe stomach pain
• Breathing difficulties (due to inhalation of the fumes or vapors); coughing
• Sudden drop in blood pressure (hypotension)
• Vision abnormalities including vision loss; partial or total blindness is a possibility
• Change in blood pH levels, resulting in several organs being affected
• Shock and/or collapse

How is First Aid administered for Trisodium Phosphate Poisoning?

First Aid tips for Trisodium Phosphate 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; 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
• Otherwise, following an ingestion of the substance, immediately give milk or water 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:

• Monitoring of vital signs
• Medically manage symptoms, such as abnormal heart rate and seizures
• Provide breathing support, if necessary
• Administer suitable medication to dilute the effects of the toxin
• Wash skin and eyes repeatedly and thoroughly (irrigation), to eliminate any remaining hazardous compound
• 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, if necessary
• Administer fluids by an intravenous drip line

Who should administer First Aid for Trisodium Phosphate Poisoning?

First aid for Trisodium Phosphate 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 Trisodium Phosphate Poisoning?

• The prognosis of Trisodium Phosphate 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
• Severity of the poisoning, the toxic ingredient present in trisodium phosphate compound, and timely medical assistance are the key prognostic indicators
• Severe exposure of body organs (mouth, throat, gastrointestinal tract including stomach) to the chemical can lead to complications and irreversible damage; deaths have been reported
• In many cases, the damage to internal organs continue to occur for a few weeks, before death of the affected individual

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 Trisodium Phosphate Poisoning be Prevented?

Trisodium Phosphate Poisoning can be prevented by:

• Always following instructions for usage of any health or cosmetic products
• Keeping household products out of reach of children in child-proof containers
• Keeping any poisonous/hazardous chemicals and other materials out of children’s reach
• Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)
• Keep all poisons correctly labeled and in suitable storage locations

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