II. Preparations: Hydrogen Peroxide
- Low Concentrations (unlikely to be toxic)
- Household Hydrogen Peroxide (3-6%)
- Beauty Product Hydrogen Peroxide for bleaching hair and teeth (10%)
- High Concentrations (toxic)
- Food grade Hydrogen Peroxide (35%)
- Used for many fad uses without scientific basis (food, home remedy)
- Industrial Hydrogen Peroxide for whitening paper, cloth (>35%)
- Food grade Hydrogen Peroxide (35%)
III. Adverse Effects
- Caustic Effects
- Oropharyngeal burns and edema with risk of airway compromise
- Gastrointestinal burns and inflammation with risk of gastrointestinal perforation
-
Air Embolism
- Catalase enzyme breaks down Hydrogen Peroxide to water and oxygen
- Every 1 ml of 35% Hydrogen Peroxide releases 100 ml oxygen when exposed to catalase
- If the oxygen bubbles that form in venous system cross to arterial circulation they embolize
IV. Management
- See Toxin Ingestion
- See Caustic Ingestion
- See ABC Management
- Evaluate for airway compromise
- Consult Gastroenterology for caustic gastrointestinal effects
- Upper Endoscopy
- Consult toxicology or poison control
- Hyperbaric oxygen may be indicated in neurologic changes
V. References
- Nordt in Herbert (2021) EM:Rap 21(1): 10-1