Letter: Danger of saline emetics in first-aid for poisoning.

Abstract

SIR,-Your leading article entitled "First-aid for Poisoning" (26 January, p. 130) states that the case for the use of most first-aid methods of inducing vomiting is "scientifically thin." It points out that the effect of taking an emetic made up with two tablespoonfuls of salt in a tumbler of tepid water is unpredictable.We have recently reported the case cf a 26-year-old woman, who died after the administration of an emetic containing 150 g of sodium chloride (6 dessertspoonfuls) in the first-aid treatment of a relatively minor overdose of an aspirin-containing analgesic.' The main features of her illness were severe metabolic acidosis and a cerebral disorder giving rise to generalized myoclonus and repeated convulsions with hyperpyrexia. Others have reported similar cases.23 Ward4 has warned that saline emetics may precipitate pulmonary oedema. Since our case occurred two further unpublished cases of coma apparently caused by saline emetics have been brought to our attention.There is evidence then that the administration of large amounts of salt to induce emesis is accompanied by considerable danger. The danger is enhanced by the widely held belief that this common household remedy is completely safe regardless of dosage. We would recommend that first-aid bocks which carry recipes for salt emetics should also warn against overdose.-We are, etc.,