[Iatrogenic hypernatremia--report of two cases].

INTRODUCTION

Despite the many side effects solutions of kitchen salt are still being used as efficient and safe homemade emetics.

CASE REPORTS: Saturated solutions of kitchen salt have been used by paramedics to provoke vomiting in two patients: a 50-years-old woman and a 44-years-old man. According to anamnesis patients received respectively around 330 and 500 g of dissolved kitchen salt. In both cases bloody emesis and bloody diarrhea, alteration of consciousness and low blood pressure were noted. Maximum blood sodium level was 177 and 173 mmol/l respectively. Due to signs of gastrointestinal bleeding gastric endoscopy was performed in both cases, which demonstrated widespread damage of gastric mucosa. Normalization of electrolyte disturbances and improvement of patients' status was achieved with intravenous infusion of 5% glucose. Both patients have been discharged to further outpatient treatment after 10-days hospitalization.

CONCLUSIONS

1. Use of salt kitchen solutions to induce emesis results in a high risk of life-threatening complications. 2. Particular emphasis must be put on training of paramedics in pre-hospital management of acute poisonings.