Ammonia poisoning

Introduction

Introduction to ammonia poisoning Ammonia is a highly water-soluble, colorless, alkaline irritating gas that strongly irritates the eyes and mucous membranes. It can be used in the manufacture of fertilizers, refrigerants, and in the production of explosives, dyes, plastics and some drugs. The strong irritancy prompts people to leave quickly, thus avoiding serious lung damage, and the ammonia released by household cleaners causes lung damage to be rare. Ammonia is mainly poisoned by inhalation in the respiratory tract. The toxicity of ammonia to the human body is related to the concentration of ammonia in the environment and the contact time. Low concentration of ammonia has a stimulating effect on the mucous membrane. High concentration of ammonia can cause tissue protein denaturation, adipose tissue saponification and other tissue dissolving necrosis (ie saponification), causing chemical inflammation and burns of the skin and upper respiratory tract mucosa, pulmonary congestion, pulmonary edema and Bleeding, ammonia inhaled into the alveoli through the respiratory tract, most of which is absorbed into the blood, causing the blood ammonia concentration to increase, causing damage to the central nervous system, first irritating after excitement, ammonia can also cause hepatic steatosis, renal interstitial inflammation and myocardial damage. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: pulmonary edema, bronchial pneumonia, respiratory failure

Cause

Ammonia poisoning cause

Cause (60%):

Ammonia is a highly water-soluble, colorless, alkaline irritating gas that strongly irritates the eyes and mucous membranes. It can be used to make fertilizers, refrigerants, and can also be used in the production of explosives, dyes, plastics and some drugs. A high chemical concentration in the presence or absence of sensation can cause ammonia poisoning.

Pathogenesis (25%):

Ammonia is a kind of easily soluble gas with severe mucosal irritation. Therefore, the main site of action is the upper airway. Accidental inhalation of high concentration can cause laryngeal edema and suffocation.

Ammonia can also cause hepatic steatosis, renal interstitial inflammation and myocardial damage.

Prevention

Ammonia poisoning prevention

1. Strengthen safety education, improve operational procedures, regularly inspect production equipment, and strengthen ventilation.

2. Pay more attention to safety and personal protection during transportation.

3. Strictly follow the operating procedures to prevent accidents.

4. In the process of producing and using ammonia, it is necessary to frequently check whether the valves and pipes are sealed, and wear a gas mask with copper sulfate or zinc sulfate during maintenance.

5. When storing and transporting ammonia cylinders, avoid exposure to sunlight, heat radiation and collisions to avoid explosions in the bottle.

Complication

Ammonia poisoning complications Complications pulmonary edema bronchopneumonia respiratory failure

Can be complicated by acute pulmonary edema, bronchial pneumonia, severe respiratory failure.

Symptom

Ammonia poisoning symptoms Common symptoms Hair dyspnea Dizziness Mucus secretion suffocation sputum Bronchospasm fatigue nausea and vomiting tears throat edema

For upper airway obstruction symptoms such as throat, wheezing, dumbness, and difficulty speaking, these patients have two to three degrees of burns on the skin, the mortality rate is about 40%, and the moderate to severe inhalation clinical process is two stages. First, within 48 to 72 hours, the clinical symptoms improved, and then worsened due to increased airway resistance, cyanosis and dyspnea or respiratory failure.

The degree of respiratory damage after inhalation of ammonia is directly related to ammonia concentration, contact time, and inhalation depth. Acute inhalation of low to moderate concentrations of ammonia (150-450 mg/m3) causes a large amount of tearing, pharyngeal stimulation and cough, which can produce lungs. Edema and chemical bronchitis, exposure to high concentrations of ammonia (450mg / m3) cause laryngeal edema, bronchitis, bronchospasm and mucus hypersecretion, can produce non-cardiogenic pulmonary edema and bronchial pneumonia, can cause suffocation death in a few minutes .

Examine

Ammonia poisoning check

Carefully check for abnormal laryngeal obstruction, mucosal damage, and gas exchange. Chest radiographs showing pulmonary edema or arterial blood gas analysis showed that patients with increased alveolar arterial oxygen pressure difference should be hospitalized for at least 24 hours. Treatment includes oxygen inhalation, bronchodilators, airway maintenance, and assisted ventilation.

Chest X-ray findings vary according to the severity of inhalation, mild contact with chest radiographs, and extensive exposure to chest radiographs showing lung edema shadows.

Diagnosis

Diagnosis and identification of ammonia poisoning

Ammonia is a kind of easily soluble gas with severe mucosal irritation, so the main site of action is the upper airway. Accidental inhalation of high concentrations can cause laryngeal edema and suffocation. It should be differentiated from acute laryngitis, bronchitis and bronchial pneumonia caused by other causes.

1. There is a history of exposure to ammonia.

2. Breathing and skin have the smell of ammonia.

3. Clinical manifestations of damage to the skin, mucous membranes, and respiratory tract.

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