Histopathologic Evaluation of the Therapeutic Efficacy of Water and Milk Dilution for Esophageal Acid Injury

Homan, Clark S.; Maitra, Soumyajit; Lane, Bernard; Thode, Henry C.; Davidson, Lev

doi:10.1111/j.1553-2712.1995.tb03594.x

Cited by 27 publications

(6 citation statements)

References 21 publications

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“…There is insufficient evidence that dilution of the ingested poison with water or milk is of any benefit as a first aid measure. Animal studies [212][213][214][215][216] have shown that dilution or neutralization of a caustic agent with water or milk reduces tissue injury, but no human studies have shown a clinical benefit. Possible adverse effects of water or milk administration include emesis and aspiration.…”

Section: Ingested Poisonsmentioning

confidence: 99%

Part 17: First Aid

Markenson¹,

Ferguson²,

Chameides³

et al. 2010

Circulation

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Section: Ingested Poisonsmentioning

confidence: 99%

Part 17: First Aid

Markenson¹,

Ferguson²,

Chameides³

et al. 2010

Circulation

View full text Add to dashboard Cite

“…One in vitro LOE 5 chemistry study 2 demonstrated no benefit from the addition of large volumes of diluent to either a strong base or a strong acid. Five LOE 5 animal studies [3][4][5][6][7] demonstrated histological benefit to the esophagus when a diluent was administered following exposure to an alkali or acid.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 13: First Aid

Markenson¹,

Ferguson²,

Chameides³

et al. 2010

Circulation

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The International First Aid Science Advisory Board identified 38 questions in first aid practice that had not been subjected to an evidence review process or that needed to be updated since the 2005 process. Two or more members of the International First Aid Science Advisory Board volunteered to independently review the scientific literature and complete an evidence-based review worksheet summarizing the literature (see Part 2 of this supplement for additional information). After the evidence was presented to the full board, a draft consensus summary of the scientific evidence and a draft consensus treatment recommendation were developed and represented at a subsequent meeting. Thus, each question, evidence-based review, draft summary of science, and draft treatment recommendation was presented and discussed on 2 separate occasions, and a Consensus on Science and Treatment Recommendation was reached by the Board. This document is a report of the group's consensus.As in 2005, the worksheets revealed the continuing paucity of scientific evidence to support specific first aid interventions. Very little research is being conducted in first aid, and most of the recommendations are extrapolations from research and experience in other medical venues, animal studies, and case series. It is hoped that this document will be a stimulus to future research in first aid. First Aid for Medical Emergencies SummaryThe medical questions addressed include poisoning, anaphylaxis, oxygen administration, and aspirin administration for a suspected coronary event.No changes were recommended for first aid management of acute poisoning.In reviewing epinephrine administration for anaphylaxis, evidence was found that laypeople and some medical and prehospital professionals are unable to recognize the signs and symptoms of anaphylaxis and therefore cannot, without training, make an independent decision to administer epinephrine with an auto-injector or to administer a second dose if the first is not effective. This issue takes on added importance in view of legislation in some jurisdictions that permits these actions.No evidence was found, except in decompression injuries, to support the routine administration of oxygen by first aid providers.The administration of aspirin to a victim experiencing chest discomfort is problematic. The literature is clear on the benefit of early administration of aspirin in an acute coronary event, except when there is a clear contraindication, such as aspirin allergy or a bleeding disorder. Less clear, however, is whether first aid providers can recognize the signs and symptoms of an acute Consensus on ScienceThere are no human studies on the effect of treating oral caustic exposure with dilution therapy. One in vitro LOE 5 chemistry study 2 demonstrated no benefit from the addition of large volumes of diluent to either a strong base or a strong acid. Five LOE 5 animal studies 3-7 demonstrated histological benefit to the esophagus when a diluent was administered following exposure to an alkali or acid. Treat...

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“…Despite the decrease in stricture formation in these experimental studies, the rate of stricture formation seen in advanced-grade corrosive esophagitis is still 70-100% (6)(7)(8)(14)(15)(16)(17)(18)(19)(20). Although the experimental studies have documented the efficiency of multiple agents, the current treatment protocol in corrosive esophagitis is still restricted to steroid, antibiotics and neutralization of the caustic agent in the early phase (13,(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%