Fatal outcome from administration of a salt emetic

Roberts, Clive J.; Noakes, MJ

doi:10.1136/pgmj.50.586.513

Cited by 19 publications

(5 citation statements)

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“…Four patients ingested excessive salt as part of a suicide attempt [15–18]. Seven patients (including our patient) were diagnosed of suffering of other psychiatric disorders [19–24]. Only one patient was a male, whilst all others were females.…”

Section: Discussionmentioning

confidence: 99%

Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L⁻¹): a disorder linked to female gender and psychiatric disorders

Ofran

Lavi

Opher

et al. 2004

Journal of Internal Medicine

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Excessive ingestion of salt is a well-recognized cause of hypernatraemia in children, is uncommonly recognized in debilitated elderly persons, but is rarely diagnosed in healthy, independent adults. We report a case of fatal salt poisoning in a 20-year-old lady who suffered of post-natal depression and ingested large quantities of salt as part of exorcism ritual. She presented with the highest ever documented serum sodium level of 255 mmol L )1 , associated with severe neurological impairment that was unresponsive to aggressive hypotonic fluid replacement. Post-mortem examination ruled out any other possible probable cause of death. The medical literature was reviewed, and 16 previous cases of severe hypernatraemia in adults secondary to excessive salt ingestion were retrieved. Common features of all reported cases included female gender (95% of cases) and evidence of underlying cognitive or psychiatric disorders (all reported cases). We conclude that women with documented cognitive or psychiatric disorders, in particular depression, are susceptible for psychogenic salt poisoning. Awareness should be raised to the potentially life-risking use of salty beverages as emetics or as part of 'exorcism' rituals.

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Section: Discussionmentioning

confidence: 99%

Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L⁻¹): a disorder linked to female gender and psychiatric disorders

Ofran

Lavi

Opher

et al. 2004

Journal of Internal Medicine

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“…The patient and their relatives panic after taking the agent or when they are bitten by a snake; hence, they try some traditional techniques to remove the toxin from the body. [1516] In our study, we found that people still used age-old method of putting finger in the mouth to stimulate pharynx or using saline water in order to induce vomiting. The practice of applying tourniquet is still prevalent in cases of snakebite.…”

Section: Discussionmentioning

confidence: 78%

Profile of acute poisoning cases and their outcome in a teaching hospital of north India

Mathew

Jamshed

Aggarwal

et al. 2019

J Family Med Prim Care

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Objectives:Aim of this study was to characterize acute poisoning and snakebite cases and their outcome in the Emergency Department (ED).Methods:This was a prospective study done in the ED of a tertiary healthcare center. Study included 184 patients of acute poisoning and 16 cases of snakebite. Data regarding demographics, type, time, and mode of poisoning, lag time in reaching the hospital, initiation of treatment, first aid, in-hospital treatment, and comorbid illness were obtained. Data regarding requirement of antidote, duration of hospitalization, and outcome were also obtained.Results:Out of 200 cases, 181 (90.5%) were adults and 19 (9.5%) were of pediatric age group. Poisoning was common among males (57%) than females (43%). Majority (40%) were from the age group of 21–30 years. Out of 200, 115 (57.5%) poisonings were suicidal, 68 (34%) were accidental, and 17 (8.5%) were homicidal. Acute poisonings included corrosive 54 (27%), drug overdose 26 (13%), organophosphorus compounds 20 (10%), rodenticides 20 (10%), and symptomatic snakebite 16 (8%). Seventy-two (36%) were admitted with a median hospital stay of 6 days with 5 (2.5%) deaths. Logistic regression analysis revealed poorer outcome for 15–30 years age [OR 12.6 (1.6–97.5), P = 0.015], males [OR 2.5 (1.4–4.4) P = 0.04], patients coming from >30 km [OR 4.3 (1.5–12.1), P = 0.006].Conclusion:Our study demonstrated an increased incidence of corrosive ingestion. With increasing rates of suicidal ingestions, there is a need for holistic approach to manage mental health issues at primary care level.

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“…Thus, 27 manuscripts reporting fatality from ingesting dietary salt were obtained. There were 35 fatalities reported, 19 in adults [ 2 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ] and 16 in children [ 6 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. The fatalities were categorized by age ( Table 2 and Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Fatalities Related to Acute Ingestion of Salt. A Need for Warning Labels?

Campbell

Train

2017

Nutrients

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There are sporadic cases of fatalities from acutely eating salt. Yet, on social media, there are “challenges to” and examples of children and some adults acutely eating salt, and recently a charity advocated eating small amounts of salt to empathize with Syrian refugees. We performed a systematic review of fatalities from ingesting salt to assess if relatively moderate doses of salt could be fatal. In 27 reports, there were 35 fatalities documented (19 in adults and 16 in children). The lethal dose was estimated to be less than 10 g of sodium (<5 teaspoons of salt) in two children, and less than 25 g sodium in four adults (<4 tablespoons of salt). The frequency of fatal ingestion of salt is not able to be discerned from our review. If investigation of the causes of hypernatremia in hospital records indicates salt overdose is relatively common, consideration could be given to placing warning labels on salt containers and shakers. Such warning labels can have the added advantage of reducing dietary salt consumption.

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Fatal outcome from administration of a salt emetic

Cited by 19 publications

References 8 publications

Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L⁻¹): a disorder linked to female gender and psychiatric disorders

Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L⁻¹): a disorder linked to female gender and psychiatric disorders

Profile of acute poisoning cases and their outcome in a teaching hospital of north India

A Systematic Review of Fatalities Related to Acute Ingestion of Salt. A Need for Warning Labels?

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Fatal outcome from administration of a salt emetic

Cited by 19 publications

References 8 publications

Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L−1): a disorder linked to female gender and psychiatric disorders

Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L−1): a disorder linked to female gender and psychiatric disorders

Profile of acute poisoning cases and their outcome in a teaching hospital of north India

A Systematic Review of Fatalities Related to Acute Ingestion of Salt. A Need for Warning Labels?

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Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L⁻¹): a disorder linked to female gender and psychiatric disorders

Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L⁻¹): a disorder linked to female gender and psychiatric disorders