Chlorine is a yellow-green irritant gas from industrial leaks or from mixing bleach with acids or ammonia at home. It forms acids on wet surfaces, which irritates the eyes and airways and can cause delayed lung injury.
Key symptoms
- Burning eyes, nose and throat
- Cough, chest tightness and wheeze
- Shortness of breath
- Nausea and headache
What you find on exam
- Scene safety: stay upwind and only trained teams with protection enter
- Breathing rate, oxygen saturation, wheeze and crackles
- Stridor or hoarse voice from upper airway swelling
- Eyes and skin for irritation
Tests
- Pulse oximetry and blood gas if distressed
- Chest X-ray for pulmonary edema
- Observe for several hours since lung injury can be delayed
Treatment basics
- Move the patient to fresh air and remove contaminated clothing
- Irrigate eyes and skin with water
- Humidified oxygen
- Nebulized albuterol for wheeze
- CPAP or intubation for severe lung injury
Red flags
- Stridor or hoarse voice
- Low oxygen saturation
- Increasing shortness of breath hours after exposure
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Related guides
Sources: NASEMSO National Model EMS Clinical Guidelines; National EMS Education Standards (2021). Written by Making Synapses. Making Synapses is not affiliated with these organizations.