Ammonium hydroxide poisoning
DefinitionAmmonium hydroxide is a colorless liquid chemical solution that forms when ammonia dissolves in water. This article discusses poisoning due to ammonium hydroxide.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 a local poison control center at 1-800-222-1222.
Alternative NamesAqueous - ammonia
Poisonous IngredientAmmonium hydroxide
Where FoundAmmonium hydroxide is found in many industrial products and cleaners such as flooring strippers, brick cleaners, and cements.Ammonium hydroxide can also release ammonia gas into the air.Ammonia alone (not ammonium hydroxide) can be found in many household items such as detergents, stain removers, bleaches, and dyes. The symptoms and treatment for ammonia exposure are similar to those for ammonium hydroxide.Note: This list may not be all inclusive.
SymptomsAirways and lungs
Breathing difficulty (from inhalation)CoughingThroat swelling (which may also cause breathing difficulty)WheezingEyes, ears, nose, and throat
Severe pain in the throatSevere pain or burning in the nose, eyes, ears, lips, or tongueVision lossEsophagus, stomach, and intestines
Blood in the stoolBurns of the esophagus (food pipe) and stomachSevere abdominal painVomiting, possibly with bloodHeart and blood
CollapseLow blood pressure (develops rapidly)Severe change in pH (too much or too little acid in the blood, which leads to damage in all of the body organs)Skin
BurnsHoles in skin tissue (necrosis)Irritation
Home TreatmentDo NOT make the person throw up.If ammonium hydroxide is on the skin or in the eyes, flush with lots of water for at least 15 minutes.If the person swallowed ammonium hydroxide, immediately give milk or water. Fruit juices may also be given. DO NOT give water, juice, 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 fumes, immediately move the patient to fresh air.
Before Calling EmergencyDetermine the following information:The patient's age, weight, and condition
The name of the product (ingredients and strengths, if known)
The time it was swallowed
The amount swallowed
Poison Control, or a local emergency numberIn the United States, call 1-800-222-1222 to speak with a local poison control center. This hotline number will let you talk to experts in poisoning. They will give you further instructions.This is a free and confidential service. 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 roomThe health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure.The patient may receive:Bronchoscopy -- camera down the throat to see burns in the airways and lungsEndoscopy -- camera down the throat to see burns in the esophagus and the stomachFluids by IVMedicines to treat symptomsOxygen and breathing supportSkin debridement (surgical removal of burned skin)Washing of the skin (irrigation) -- perhaps every few hours for several days Some patients may be admitted to the hospital.
Expectations (prognosis)Survival past 48 hours usually indicates recovery will occur. If a chemical burn occurred in the eye, permanent blindness will probably result.How well a patient does depends on the strength of the chemical and how fast the poison was diluted and neutralized. Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible.The ultimate outcome depends on the extent of this damage. Damage continues to occur to the esophagus and stomach for several weeks after the poison was swallowed, and death may occur as long as a month later.
ReferencesHarchelroad FP Jr, Rottinghaus DM. Chemical burns. 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 200.