Hydrogen Bromide

CAS RN:10035-10-6

Laboratory

A) Monitor serum electrolytes, renal function, and fluid status carefully. Spuriously elevated chloride level and low anion gap are characteristic of bromism due to laboratory interference by the bromide ion.
B) Serum bromide concentrations should be monitored in patients with significant CNS effects.
C) Consider abdominal x-ray as bromide is radiopaque. Abdominal x-ray may be helpful in confirming diagnosis of acute ingestion.
A) Obtain a complete blood count and electrolytes in all patients with significant burns after acid ingestion.
B) In patients with signs and symptoms suggesting severe burns, perforation, or bleeding (or adults with deliberate, high volume or high concentration ingestions), obtain renal function tests, liver enzymes, serial CBC, INR, PT, PTT, fibrinogen, fibrin degradation products, type and crossmatch for blood, and monitor urine output and urinalysis. Serum lactate and base deficit may also be useful in these patients.
C) Monitor pulse oximetry or arterial blood gases in patients with signs and symptoms suggestive of upper airway edema or burns.
D) Obtain an upright chest x-ray in patients with signs and symptoms suggesting severe burns, perforation, or bleeding (or adults with deliberate, high volume or high concentration ingestions) to evaluate for pneumomediastinum or free air under the diaphragm. The absence of these findings DOES NOT rule out the possibility of necrosis or perforation of the esophagus or stomach. Obtain a chest radiograph in patients with pulmonary signs or symptoms.
E) Several weeks after ingestion, barium contrast radiographs of the upper GI tract are useful in patients who sustained grade 2 or 3 burns, to evaluate for strictures.
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