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Ammonia poisoning

 

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 article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

The poisonous ingredient is:

  • Ammonia

Where Found

 

Ammonia can be found in:

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

Note: This list may not be all-inclusive.

 

Symptoms

 

Symptoms can affect many parts of the body. 

Airways, lungs, and chest:

  • Cough
  • Chest pain (severe)
  • Chest tightness
  • Difficulty breathing
  • Rapid breathing
  • Wheezing

Body-wide symptoms:

  • Fever

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:

  • Confusion
  • Difficulty walking
  • Dizziness
  • Lack of coordination
  • Restlessness
  • Stupor (altered level of consciousness)

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 Care

 

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 told otherwise by a health care provider. DO NOT give water or milk if the person is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.

If the poison was inhaled, immediately move the person to fresh air.

 

Before Calling Emergency

 

Determine the following information:

  • Person'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

 

Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This 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.

 

What to Expect at the Emergency Room

 

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

  • Airway and breathing support, including oxygen. In extreme cases, a tube may be passed through the mouth into the lungs to prevent aspiration. A breathing machine (ventilator) would then be needed.
  • Bronchoscopy, which involves inserting a  camera into the throat, bronchial tubes, and lungs to check for  burns in those tissues.
  • Chest x-ray.
  • EKG (electrocardiogram, or heart tracing).
  • Endoscopy - a camera down the throat to see burns in the esophagus and stomach.
  • Fluids through a vein (by IV).
  • Medicines to treat symptoms.

 

Outlook (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 most often indicates recovery will occur. Chemical burns that occurred in the eye frequently heal; however, permanent blindness may result.

 

 

References

Kulig K. General approach to the poisoned patient. In: Marx J, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 147.

Levine MD, Zane R. Chemical injuries. In: Marx J, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 64.

Nelson LS, Hoffman RS. Inhaled toxins. In: Marx J, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 159.

 

        A Closer Look

         

          Self Care

           

            Tests for Ammonia poisoning

             

               

              Review Date: 11/28/2016

              Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

              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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