HYDROGEN-PEROXIDE - A SOURCE OF LETHAL OXYGEN EMBOLISM - CASE-REPORT AND REVIEW OF THE LITERATURE

Hydrogen peroxide is a readily available clear, odorless liquid that i s commonly used as an irrigant for superficial wounds. It is not widel y thought of as a poison; however, it may rarely be the cause of accid ental death. A case of fatal oxygen embolism in a child after ingestio n of hydrogen peroxide is reported. A total of five similar cases have been previously described. Morbidity and mortality have also been rep orted with the use of hydrogen peroxide in hospitals. Gastric cataboli sm of hydrogen peroxide produces oxygen and water. When the amount of oxygen evolved exceeds its maximal blood solubility, venous embolizati on occurs. Hydrogen peroxide should not be considered to be innocuous; it should neither be ingested nor used in situations where the evolve d oxygen gas cannot dissipate freely. The ubiquitous nature of househo ld peroxide and its erroneous benign reputation suggest that child-res istant containers are in order. A protocol delineating the medicolegal investigation and postmortem examination bf fatalities caused by the ingestion of this substance is offered.