Ammonia poisoning

Answer 1

Definition

Ammonia is a strong, colorless gas. If the gas is dissolved in water, it is called liquid ammonia. Poisoning may occur if you breathe in ammonia. Poisoning may also occur if you swallow or touch products that contain very large amounts of ammonia.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient

• Ammonia

Where Found

• Ammonia gas
• Some household cleaners
• Some linaments
• Some fertilizers

Note: This list may not be all inclusive.

Symptoms

• Airways, lungs, and chest
  • Cough
  • Chest pain (severe)
  • Chest tightness
  • Difficulty breathing
  • Wheezing
• Eyes, ears, nose, mouth, and throat
  • Tearing and burning of eyes
  • Temporary blindness
  • Throat pain (severe)
  • Mouth pain
  • Lip swelling
• Heart and blood
  • Rapid, weak pulse
  • Collapse and shock
• Nervous system
  • Altered mental state
  • Fever
  • Restlessness
• Skin
  • Bluish-colored lips and fingernails
  • Severe burns if contact is longer than a few minutes
• Stomach and gastrointestinal tract
  • Severe stomach pain
  • Vomiting

Home Treatment

Do NOT make a person throw up unless told to do so by poison control or a health care professional. Seek immediate medical help.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the chemical was swallowed, immediately give the person water or milk, unless instructed otherwise by a health care provider. Do NOT give water or milk if the patient is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.

If the person breathed in the poison, immediately move him or her to fresh air.

Before Calling Emergency

Determine the following information:

• Patient's age, weight, and condition
• Name of product (as well as the ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Bloood and urine tests will be done. The patient may receive:

• Breathing support
• Continued flushing of the eyes and skin
• Fluids through a vein (IV)
• Endoscopy -- camera down the throat to see burns to the esophagus and the stomach
• Medicines to treat the symptoms

Expectations (prognosis)

Damage is related to the amount and strength (concentration) of the ammonia. Most household cleaners are relatively weak and cause little or mild damage. Industrial strength cleaners can cause severe burns and injury.

Survival past 48 hours usually indicates recovery will occur. Chemical burns that occurred in the eye frequently heal; however, permanent blindness may result.

References

White SR, Eitzen EM Jr, Klein KR. Toxicology of hazardous chemicals. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 185.

Answer 2

Definition

Ammonia is a strong, colorless gas. If the gas is dissolved in water, it is called liquid ammonia. Poisoning may occur if you breathe in ammonia. Poisoning may also occur if you swallow or touch products that contain very large amounts of ammonia.

WARNING: Never mix ammonia with bleach. This causes the release of toxic chlorine gas, which can be deadly.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient

• Ammonia

Where Found

• Ammonia gas
• Some household cleaners
• Some liniments
• Some fertilizers

Note: This list may not be all-inclusive.

Symptoms

• Airways, lungs, and chest
  • Cough
  • Chest pain (severe)
  • Chest tightness
  • Difficulty breathing
  • Wheezing
• Eyes, ears, nose, mouth, and throat
  • Tearing and burning of eyes
  • Temporary blindness
  • Throat pain (severe)
  • Mouth pain
  • Lip swelling
• Heart and blood
  • Rapid, weak pulse
  • Collapse and shock
• Nervous system
  • Altered mental state
  • Fever
  • Restlessness
• Skin
  • Bluish-colored lips and fingernails
  • Severe burns if contact is longer than a few minutes
• Stomach and gastrointestinal tract
  • Severe stomach pain
  • Vomiting

Home Treatment

Do NOT make a person throw up unless told to do so by poison control or a health care professional. Seek immediate medical help.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the chemical was swallowed, immediately give the person water or milk, unless instructed otherwise by a health care provider. Do NOT give water or milk if the patient is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.

If the person breathed in the poison, immediately move him or her to fresh air.

Before Calling Emergency

Determine the following information:

• Patient's age, weight, and condition
• Name of product (as well as the ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood and urine tests will be done. The patient may receive:

• Breathing support
• Continued flushing of the eyes and skin
• Fluids through a vein (IV)
• Endoscopy -- camera down the throat to see burns to the esophagus and the stomach
• Medicines to treat the symptoms

Expectations (prognosis)

Damage is related to the amount and strength (concentration) of the ammonia. Most household cleaners are relatively weak and cause little or mild damage. Industrial strength cleaners can cause severe burns and injury.

Survival past 48 hours usually indicates recovery will occur. Chemical burns that occurred in the eye frequently heal; however, permanent blindness may result.

References

Goldfrank LR, Flomenbaum NE, Lewin NA, et al, eds. Goldfrank's Toxicologic Emergencies. 8th ed. New York, NY: McGraw Hill; 2006.

Ford M, Delaney KA, Ling L, Erickson T, eds. Clinical Toxicology. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2001.

Reviewed By

Review Date: 08/03/2011

Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.