Sodium Hydroxide (NaOH)
Quick Reference
What is NaOH?
Can be either crystalline or an aqueous solution; it is basic and highly caustic. Used in industries such as pulp production. Also found in household products such as drain cleaner. Transported in large quantities. Non-combustible, but releases toxic fumes if heated. Toxic vapors from concentrations over 4%.
Crew Safety
- Staging/Perimeter
- Industrial: Spill: 50m until spill has been isolated. Fire: 800 m
- Residential: Limited exposure to small volumes (i.e. drain cleaner): no staging. Large amounts may be found in settings such as clandestine labs. Stage if concerned.
- Additional Resources
- Large spill: Rescue team with chemical protective clothing and SCBA’s in case of toxic vapor.
- Small, non-industrial exposure (ie. Drain cleaner): no additional resources needed.
- PPE requirements
- Our nitrile gloves are too thin to handle directly. OK for incidental exposure to dilute run-off.
- Eye protection is a must-have. It is non-optional.
- Safely initiating patient contact
- Rescue team or patient to initiate decontamination to avoid incidental exposure to concentrated NaOH. Consider callback to initiate decontamination prior to arrival.
Effect on the Patient
Saponification leading to significant tissue damage. Eye exposure has high risk of blindness. If present, vapors will act as an airway irritant. Ingestion causes saponification of upper airway and GI tract.
Patient Decontamination
Eyes take priority. If eye exposure occurred, continuous flushing until testing with a pH strip confirms pH = 7. Remove clothing without pulling over the head. Leave clothes on scene. Flush exposed skin for a minimum of 30 minutes with water. To avoid paramedic exposure, initial decontamination to be performed by rescue team or the patient. After initial flushing residual NaOH will be sufficiently dilute to provide care.
Patient Treatment
- Flushing eyes and skin as indicated.
- Analgesia and supportive care as required.
- If ingested do not induce vomiting. Patient may rinse mouth with N/S or water if able.
Safe Transfer of Care
- If eye’s exposed, relay to receiving provider that flushing must continue until pH=7 is confirmed.
- Provided sufficient external decontamination occurred, no risk to hospital staff.
Paramedic and Equipment Decontamination
No special decontamination steps are needed if no direct paramedic exposure. If contaminated clothing transported: double bag before disposal and air-out patient compartment.
DPIC Monograph
Paramedic Specialist Monograph
Emergency Response Guidebook
Revision History
| Version | Date | Changes | Author |
|---|---|---|---|
| 1.0 | 2026-05-01 | Initial version | Clinical Hub |