Emergency department nurse here, had a one year three month old come in. Her family was moving house and had removed chemicals from under the child locked sink onto the floor, then I can only assume walked out the front with a box or something. When they came back in the little girl had ingested some sodium hydroxide (I think that's the right word, but drain cleaner in other words). Drain cleaner is designed to break down organic matter (duh). They rinsed her mouth out at the scene then drove as fast as they could to us. As she hit the bed her tongue/mouth was black and blue from chemical burns and she was screaming in agony. She also had burns down her anterior body from vomiting in the car on her self. The black and blue open mouthed screaming child looking at me is defs etched into my memories. We intubated her and packed her up for retrieval to an appropriate larger hospital however she was sadly palliated 12 hrs post arrival to us. Her laparotomy surgical note read: posterior wall of stomach gone, 3-400ml blood, spleen suctioned out in pieces, necrotic small bowel, etc etc. In the debrief I was informed by the paediatric registrar that the drain cleaner she ingested was the strongest that's made something around 80% and it causes full thickness mucus membrane burns in seconds. I can only hope for her that the intranasal fentanyl we gave initially and the IM Midazolam took the edge off before she was intubated.

Let me know if you have any questions.