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    Ammonium hydroxide poisoning

    Aqueous - ammonia

    Ammonium 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.

    Poisonous Ingredient

    Ammonium hydroxide

    Where Found

    Ammonium hydroxide is found in many industrialproducts and cleaners such asflooring 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.

    Symptoms

    • Airways and lungs
      • Breathing difficulty (from inhalation)
      • Coughing
      • Throat swelling (which may also cause breathing difficulty)
      • Wheezing
    • Eyes, ears, nose, and throat
      • Severe pain in the throat
      • Severe pain or burning in the nose, eyes, ears, lips, or tongue
      • Vision loss
    • Esophagus, stomach, and intestines
      • Blood in the stool
      • Burns of the esophagus (food pipe) and stomach
      • Severe abdominal pain
      • Vomiting, possibly with blood
    • Heart and blood
      • Collapse
      • Low 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
      • Burns
      • Holes in skin tissue (necrosis)
      • Irritation

    Home Care

    Do 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 Emergency

    Determine 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

    In 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 Room

    The 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 lungs
    • Endoscopy -- camera down the throat to see burns in the esophagus and the stomach
    • Fluids by IV
    • Medicines to treat symptoms
    • Oxygen and breathing support
    • Skin 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.

    Outlook (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 wasdiluted 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.

    References

    Harchelroad 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.

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          A Closer Look

            Tests for Ammonium hydroxide poisoning

              Review Date: 9/12/2012

              Reviewed By: A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Eric Perez, MD, St. Luke's / Roosevelt Hospital Center, NY, NY, and Pegasus Emergency Group (Meadowlands and Hunterdon Medical Centers), NJ. Review provided by VeriMed Healthcare Network (12/15/2011).

              The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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