Glutaraldehyde

CAS RN: 111-30-8

Treatment Overview

0.4.2 ORAL EXPOSURE
  • A) MANAGEMENT OF MILD TO MODERATE TOXICITY
    • 1) Treatment is symptomatic and supportive. INGESTION: There have been rare reports of glutaraldehyde oral exposure. The patient may be at risk to develop pain, difficulty swallowing, irritation or potentially more severe gastrointestinal injury. Assess oral mucosa and consider esophagoscopy if the patient appears symptomatic (ie, pain, difficulty swallowing, drooling). Monitor fluid status and electrolytes in patients that develop significant vomiting. ENDOSCOPIC PROCEDURES: Infrequent reports of exposure to glutaraldehyde solution following endoscopic procedures (ie, sigmoidoscopy, colonoscopy) have occurred resulting in colitis in some patients. Gastrointestinal symptoms (eg, abdominal pain, watery diarrhea) are usually self-limited and resolve within a few days. Monitor fluid and electrolytes in patients with persistent symptoms. Replace fluids and electrolytes as indicated. Gastrointestinal bleeding is a rare finding. INHALATION: Treatment is symptomatic and supportive. Remove patient from glutaraldehyde vapors as needed. Assess respiratory effort and function. Patients with chronic occupational exposure may require ongoing evaluation of respiratory function (ie, pulmonary function studies), a combination of drug therapies (eg, corticosteroids, sympathomimetics) and permanent removal from the chemical as needed. DERMAL: Decontaminate skin with soap and water following exposure. Monitor for ongoing symptoms. OCULAR: Irrigate eyes with copious amounts of water. An ophthalmic exam may be necessary if symptoms persist.
  • B) MANAGEMENT OF SEVERE TOXICITY
    • 1) Treatment is symptomatic and supportive. ACUTE: Monitor gastrointestinal and respiratory effort following ingestion. CHRONIC: Glutaraldehyde-induced occupational asthma has been reported in some healthcare workers with a chronic exposure. Ongoing respiratory evaluation and support may be necessary in patients that develop persistent symptoms despite removal from the chemical.
  • C) DECONTAMINATION
    • 1) PREHOSPITAL: INGESTION: Because of the potential for further gastrointestinal injury, do NOT induce emesis. Activated charcoal is generally not recommended due to the risk of producing emesis and/or obscuring endoscopic findings, if endoscopy is needed. DERMAL: Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists. OCULAR: Exposed eyes should be irrigated copiously with water for at least 15 minutes. An ophthalmic examination should be considered if irritation or pain persists thereafter. Glutaraldehyde in concentrations as low as 2% may cause ocular damage (severe inflammation, lacrimation, and edema).
    • 2) HOSPITAL: INGESTION: Activated charcoal is not recommended as it may interfere with endoscopy, if needed. Consider insertion of a small, flexible nasogastric or orogastric tube to aspirate gastric contents after a recent significant ingestion of glutaraldehyde. The risk of worsening mucosal injury must be weighed against the potential benefit. DERMAL: Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists. OCULAR: Exposed eyes should be irrigated copiously with water for at least 15 minutes. An ophthalmic examination should be considered if irritation or pain persists thereafter. Glutaraldehyde in concentrations as low as 2% may cause ocular damage (severe inflammation, lacrimation, and edema).
  • D) AIRWAY MANAGEMENT
    • 1) Move patient to fresh air following an acute exposure to glutaraldehyde vapor. Monitor respiratory effort and function. Obtain a baseline pulse oximetry or ABGs in patients that develop evidence of respiratory symptoms. Although infrequently reported, ingestion of glutaraldehyde solution produced laryngeal edema in a young adult requiring intubation and mechanical ventilation.
  • E) ANTIDOTE
    • 1) There is no known antidote.
  • F) ENHANCED ELIMINATION
    • 1) It is unknown if glutaraldehyde would be removed by enhanced elimination procedures.
  • G) PATIENT DISPOSITION
    • 1) HOME CRITERIA: Patients with mild eye or skin irritation can be managed at home with decontamination. Persistent symptoms following decontamination may require further evaluation by a healthcare provider. Patients with an intentional ingestion of glutaraldehyde should be evaluated in a healthcare setting to assess for gastrointestinal injury or systemic toxicity.
    • 2) OBSERVATION CRITERIA: Patients with significant eye irritation, or more than mild pulmonary or skin irritation should be sent to a healthcare facility for evaluation and treatment as indicated.
    • 3) ADMISSION CRITERIA: Patients with evidence of ongoing (eg, pulmonary injury following an acute exposure) symptoms should be admitted to a monitored setting.
    • 4) CONSULT CRITERIA: Consult a poison center or medical toxicologist for assistance in managing a severe poisoning.
0.4.3 INHALATION EXPOSURE
  • A) Move patient to fresh air following an acute exposure to glutaraldehyde vapor and monitor for respiratory distress.
0.4.4 EYE EXPOSURE
  • A) Exposed eyes should be irrigated copiously with water for at least 15 minutes. An ophthalmic examination should be considered if irritation or pain persists thereafter. Glutaraldehyde in concentrations as low as 2% may cause ocular damage (severe inflammation, lacrimation, and edema).
0.4.5 DERMAL EXPOSURE
  • A) OVERVIEW
    • 1) Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists.
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