Automatic dishwasher soap poisoning

Automatic dishwasher products contain various soaps. Potassium carbonate and sodium carbonate are the most common.

Standard liquid household detergents and soaps rarely cause serious injury if swallowed accidentally. However, single-use laundry or dishwasher detergent packets, or "pods" are more concentrated. Therefore, they are more likely to damage the esophagus.

The poisonous ingredients are found in automatic dishwasher soaps.

Symptoms of automatic dishwasher soap poisoning can affect many parts of the body.

EYES, EARS, NOSE, AND THROAT 

• Severe pain in the throat
• Severe pain or burning in the nose, eyes, ears, lips, or tongue
• Loss of vision
• Throat swelling (which may also cause breathing trouble)

HEART AND BLOOD CIRCULATION 

• Low blood pressure - develops quickly
• Collapse
• Severe change in blood acid levels, which can lead to organ damage

LUNGS

• Breathing difficulty (from breathing in the poison)

SKIN

• Irritation
• Burns
• Necrosis (tissue death) in the skin or tissues underneath

STOMACH AND INTESTINES

• Severe abdominal pain
• Vomiting, may be bloody
• Burns of the esophagus (food pipe)
• Blood in the stool

Seek immediate emergency medical help. DO NOT make the person throw up.

If the soap is in the eyes, flush with lots of water for at least 15 minutes.

If the soap was swallowed, have the person immediately drink water or milk.

Determine the following information:

• The person's age, weight, and condition
• The name of the product (ingredients and strengths, if known)
• The time it was swallowed
• The amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood and urine tests will be done. Symptoms will be treated as needed. The person may receive:

• Activated charcoal to help prevent the remaining poison from being absorbed into the stomach and digestive tract.
• Airway and breathing support, including oxygen. In extreme cases, a tube may be passed through the mouth into the lungs to prevent aspiration. A breathing tube (ventilator) would then be needed.
• Blood transfusion if severe blood loss has occurred.
• Chest x-ray.
• ECG (electrocardiogram, or heart tracing).
• Fluids through a vein (IV).
• Endoscopy -- a camera down the throat to see burns in the esophagus and stomach.
• Medicines (laxatives) to move the poison quickly through the body.
• Tube through the mouth into the stomach to wash out the stomach (gastric lavage). This is rare.
• Medicines to treat symptoms, such as nausea and vomiting, or those of an allergic reaction, such as swelling of the face or mouth or wheezing (diphenhydramine, epinephrine, or steroids).

Most cases of swallowing dishwasher soap are not that harmful. How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery.

Swallowing poisons can have severe effects on many parts of the body. Damage can continue to occur to the esophagus and stomach for several weeks after the product is swallowed. Death may occur up to a month after the poisoning.

Davis MG, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Pediatric exposures to laundry and dishwasher detergents in the United States: 2013-2014. Pediatrics. 2016;137(5): e20154529. PMID: 27244825 pubmed.ncbi.nlm.nih.gov/27244825/.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Yasuda JL, Manfredi MA. Caustic ingestion and foreign bodies. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 18.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.