Suicidal Ingestion of Barium-Sulfide-Containing Shaving Powder

Downs, James C.; Milling, D. Allison; Nichols, Clay A.

doi:10.1097/00000433-199503000-00013

Cited by 30 publications

(10 citation statements)

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“…Peak serum level occurs 2 hours after ingestion with an elimination half life of 3.6 days. The systemic effects of Barium are linked with two modes of action: direct muscular stimulation (skeletal, cardiac, and smooth), and hypokalaemia [3,4]. The latter effect is associated with the ability of the barium ion to block potassium (K+) channels and interfere with passive K+ diffusion [4,5].…”

Section: Introductionmentioning

confidence: 99%

Mass barium carbonate poisoning with fatal outcome, lessons learned: a case series

Ghose

Sayeed

Hossain

et al. 2009

Cases J

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IntroductionBarium, a heavy divalent alkaline metal, has long been known to cause human toxicity. The common mode is accidental ingestion and the common compound is Barium carbonate. Here we report an incident of food poisoning in 27 law enforcement personnel with rapidly developing sequelae and a high mortality due to ingestion of Barium carbonate contaminated flour.Case presentationOne midnight, 27 adult males were rushed to emergency department of Chittagong Medical College Hospital with abdominal pain, vomiting, loose motion, cramps and generalized paraesthesia. The ailment started 1-2 hours after Iftar (evening meal to break day long fast during Ramadan) which included fried vegetables coated with a flour paste. On admission, twenty of them were restless, agitated. 22 reported weakness of limbs and were unable to walk. 10 had hypotension. 22 had rapid and shallow respiration. 5 had carpopedal spasm. Different grades of limb weakness were noted with loss of tendon jerks. Ten (N12) patients had hypokalaemia, three had hypoglycaemia, 4 patients had high creatine kinase. ECG showed flat ST with U waves in 4 patients. Potassium containing intravenous fluid and Oxygen was administered. Due to limited availability of mechanical ventilators patients were put on artificial respiration using Ambu bag; manually maintained by doctors, paramedics and attendants. Four patients were transferred to another hospital for mechanical ventilation. A total of 12 patients died over next 16 hours, 4 within 3 hrs. Other patients gradually improved. Chemical analysis of the vomitus, blood and flour used for preparation of meal revealed the presence of Barium. It was assumed that the flour was contaminated with the similar looking Barium carbonate powder which was kept in the kitchen as a rodenticide.ConclusionThis event exemplifies the weakness of usual health care facility in resource poor settings to cope with this kind of massive poisoning event. The multiple reported incidences of accidental barium poisoning due to unintentional mixing with food signifies the fact that the use and availability of barium carbonate should be restricted. We hope to draw attention to this relatively uncommon poisoning and to the need for development of poison information centre in resource poor countries.

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Section: Introductionmentioning

confidence: 99%

Mass barium carbonate poisoning with fatal outcome, lessons learned: a case series

Ghose

Sayeed

Hossain

et al. 2009

Cases J

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“…Intoxication – by way of ingestion, inhalation or cutaneous exposure – with soluble barium salts such as barium sulfide (1–4) (used in depilatories), barium carbonate (5–9) (a rodenticide) and barium chloride (10–13) is a rare but well‐known cause of severe hypokalemia. Neither in case reports (14) nor in animal experiments (15) is there a clear correlation between dose and severity of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Acute barium nitrate intoxication treated by hemodialysis

Bahlmann

Lindwall

Persson

2005

Acta Anaesthesiol Scand

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A 22-year-old male was admitted to hospital with diarrhea and vomiting, cardiac arrhythmias, severe hypokalemia and gradual onset of muscular weakness. A potassium infusion was started, but for several hours serum potassium remained low. Evidence of toxic ingestion was initially lacking. When it became clear -- after a considerable delay -- that the patient had ingested barium nitrate, hemodialysis was started. This resulted in rapid clinical improvement with correction of hypokalemia and restored muscular function. Intoxication with barium causes hypokalemia, arrhythmias, muscular weakness and paralysis, often requiring respiratory support. This patient presented with symptoms typical of severe barium intoxication, non-responsive to potassium supplementation. There are few published reports on the use of hemodialysis in barium poisoning. This case confirms the possible benefit of hemodialysis in severe cases, where potassium supplementation alone is insufficient.

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“…Barium is excreted in stool and, to a lesser extent, in urine, the remainder is largely incoporated into bone. Victims develop gastrointestinal, cardiovascular, respiratory and neuromuscular symptoms [Newton et al, 1977;Stewart and Hummel, 1984;Shankle and Keane, 1988;Johnson and VanTassel, 1991;Olson, 1994;Downs et al, 1995].…”

Section: Discussionmentioning

confidence: 99%