This is the podcast, ICU rounds.

My name is Dr. Jeffrey Guy.

I'm an associate professor of surgery and director of the Burns Center at the Vanderbilt University School of Medicine in Nashville, Tennessee.

Welcome back to the podcast.

The topic that we're going to talk about today is something that we have had a rash of in the past several months, and that's caustic ingestions, people drinking things that are just absolutely out of this world.

Typically, we see a lot of more of the alkali-type ingestions, but we've had people drink things like

battery acid and hydrofluic acid. And the spectrum of patients who present with this problem

have ranged from people who have rather profound toxodromes and have progressed rapidly

to death, people who have done just fine, and people who have required

rather significant operations. It's not something we see commonly, but being in a burn

center, we do see it with some regularity and perhaps more regularity than a general intensive

care unit. But it's still something interesting, and it's something I think that when patients

present, that people have to kind of take pause and think, well, what is the right way to approach this patient,

how to take care of them?

So let's talk a little bit about an update on the management of caustic exposures.

According to the American Association of Poison Control Center's toxic exposure surveillance system,

in the year 2004, there were roughly 200,000 exposures to various caustic substances,

and this is both a household and industrial-type settings.

Include things such as hydrochloric acid, potassium hydroxide, sodium hydroxide, sulfuric acid,

as well as many others.

Although the most commonly affected areas of the body are things such as the face, the eyes, and the extremities, all reported fatalities really were a result of ingestion.

Little controversy exists in patient management following dermal or occlusive exposure, but there is a significant amount of controversy regarding

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