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Oxalate Poisoning Treatment & Management

  • Author: Jason F Kearney, MD, MBA; Chief Editor: Asim Tarabar, MD  more...
 
Updated: Dec 29, 2015
 

Prehospital Care

See the list below:

  • Decontaminate mouth, eye, and skin by physically removing all plant material.
  • Treat eye and skin exposure with copious water irrigation.
  • Rescuers should protect themselves from contact with plant materials.
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Emergency Department Care

Most exposures are self-limited and only require analgesics for patient comfort.

For oral exposures, physically remove any plant material in the oral cavity. Assess for any airway compromise. Individuals without airway compromise can drink cold liquids and eat crushed ice, ice cream, or frozen ice pops or desserts for relief. Oral swishing with diphenhydramine elixir provides local anesthetic and antihistaminic effects. Individuals with laryngeal edema may be treated with antihistamines and observed and/or admitted until edema improves. No clinical data support use of steroids in laryngeal edema induced by oxalate-containing plants.

Treat eye exposures with copious water irrigation. Employ slit lamp examination and fluorescein staining to rule out corneal involvement.

Skin exposures require irrigation with fluid and local wound care. Some individuals may develop a contact dermatitis.

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Consultations

Nearly all cases of houseplant exposures involving oxalate-containing plant species are managed at home in consultation with a regional poison control center. Poison control centers may be helpful with plant identification, particularly if a fax copy or digital picture of the plant can be transmitted.

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Contributor Information and Disclosures
Author

Jason F Kearney, MD, MBA Facility Medical Director, Emergency Department, TeamHealth Providence Centralia

Jason F Kearney, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

William K Chiang, MD Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Chief of Service, Department of Emergency Medicine, Bellevue Hospital Center

William K Chiang, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

Additional Contributors

Miguel C Fernandez, MD, FAAEM, FACEP, FACMT, FACCT Associate Clinical Professor, Department of Surgery/Emergency Medicine and Toxicology, University of Texas School of Medicine at San Antonio; Medical and Managing Director, South Texas Poison Center

Miguel C Fernandez, MD, FAAEM, FACEP, FACMT, FACCT is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Medical Toxicology, Society for Academic Emergency Medicine, Texas Medical Association, American College of Occupational and Environmental Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Michael Hodgman, MD Assistant Clinical Professor of Medicine, Department of Emergency Medicine, Bassett Healthcare

Michael Hodgman, MD is a member of the following medical societies: American College of Medical Toxicology, American College of Physicians, Medical Society of the State of New York, and Wilderness Medical Society

Disclosure: Nothing to disclose.

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