Chloramine - Revision history

Danbot: Add MedicationDose entries for albuterol, dexamethasone, methylprednisolone

2026-03-20T21:22:03Z

Add MedicationDose entries for albuterol, dexamethasone, methylprednisolone

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 *Consider repeat X-ray
 *Consider admission or in house observation for asthmatics/COPD patients or those with continued symptoms after 4-6 hours
 ==See Also==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T23:16:22Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 23:16, 22 July 2016
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	{{SOB DDX}}		{{SOB DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*History of using home cleaning agents in an enclosed space		*History of using home cleaning agents in an enclosed space

Neil.m.young: Text replacement - "5 mg" to "5mg"

2016-07-19T12:47:57Z

Text replacement - "5 mg" to "5mg"

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	*Oxygen as need for low O2 saturation		*Oxygen as need for low O2 saturation
	*[[Albuterol]]		*[[Albuterol]]
	**2.5-~~5 mg~~ nebulized Q20 minutes or continuous nebulizer		**2.5-5mg nebulized Q20 minutes or continuous nebulizer
	*Intravenous [[steroids]]		*Intravenous [[steroids]]
	**[[Dexamethasone]]		**[[Dexamethasone]]

Neil.m.young: Text replacement - "6 mg" to "6mg"

2016-07-19T06:44:58Z

Text replacement - "6 mg" to "6mg"

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	*Intravenous [[steroids]]		*Intravenous [[steroids]]
	**[[Dexamethasone]]		**[[Dexamethasone]]
	***0.~~6 mg~~/kg IV or PO (max ~~16 mg~~)		***0.6mg/kg IV or PO (max 16mg)
	**[[Methylprednisolone]]		**[[Methylprednisolone]]
	***Adults- 125mg IV		***Adults- 125mg IV

Ostermayer: Text replacement - "Category:Tox" to "Category:Toxicology"

2016-03-22T16:22:41Z

Text replacement - "Category:Tox" to "Category:Toxicology"

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	<references/>		<references/>

	[[Category:~~Tox~~]]		[[Category:Toxicology]]

Cchoff: chloramine

2015-10-27T19:53:19Z

chloramine

← Older revision		Revision as of 19:53, 27 October 2015
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	==See Also==		==See Also==
	*[[Toxicology (Main)]]		*[[Toxicology (Main)]]
			*[[Inhalation exposure]]

	==External Links==		==External Links==

Cchoff: Chloramine

2015-10-16T20:46:23Z

Chloramine

← Older revision		Revision as of 20:46, 16 October 2015
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	==References==		==References==
	<references/>		<references/>

			[[Category:Tox]]

Cchoff: Chloramine

2015-10-16T20:39:47Z

Chloramine

← Older revision		Revision as of 20:39, 16 October 2015
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	==See Also==		==See Also==
			*[[Toxicology (Main)]]

	==External Links==		==External Links==

Cchoff: Chloramine

2015-10-16T20:37:35Z

Chloramine

New page

==Background==
*Derivative of ammonia with substitution of 1-3 hydrogen ions by chlorine.
**Monocholramine NH2Cl
**Dichloramine NHCl2
**Nitrogen trichloride NCl3
*Inhalation causes chloramines to react with moist mucus membranes releasing ammonia, hydrogen chloride, and oxygen free radicals<ref>Tanen, David A., Kimberlie A. Graeme, and Robert Raschke. "Severe Lung Injury after Exposure to Chloramine Gas from Household Cleaners." <i>New England Journal of Medicine N Engl J Med</i> 341.11 (1999): 848-49. <i>New England Journal of Medicine</i>. Web. 16 Oct. 2015.</ref>

*Produced with the mixing of household cleaning agents containing ammonia and bleach
**Most common form of exposure
*Thousands of exposures annually but few people seek medical attention as most exposures are mild.

==Clinical Features==
;Inhalation exposure
*Dyspnea
*Upper airway irritation
*Cough
*Wheezing
*Rarely; Stridor and upper airway edema

;Complications
*Chemical pneumonitis
*Non cardiogenic [[pulmonary edema]]

==Differential Diagnosis==
{{SOB DDX}}

==Diagnosis==
*History of using home cleaning agents in an enclosed space

==Management==
''Symptoms may be worse in patient's with [[asthma]] or [[COPD]]''
*Most patients will not require any treatment
*Consider X-ray

*Oxygen as need for low O2 saturation
*[[Albuterol]]
**2.5-5 mg nebulized Q20 minutes or continuous nebulizer
*Intravenous [[steroids]]
**[[Dexamethasone]]
***0.6 mg/kg IV or PO (max 16 mg)
**[[Methylprednisolone]]
***Adults- 125mg IV
***Children- 2mg/kg IV
*[[Epinephrine]] nebulized
**Consider for patient's with stridor, voice changes, or continuous dyspnea despite aforementioned treatment

*If the exposure is severe and the patient is unstable or continues to decline despite management above then consider [[intubation]]
**Consider awake fiberoptic [[intubation]] given upper airway swelling/edema
**Prepare for [[cricothyrotomy]] simultaneously if [[intubation]] fails

==Disposition==
*Most patients can be observed for 4-6 hours in the ED<ref>US National Library of Medicine. TOXNET: Toxicology Data Network.</ref>
*If asymptomatic after observation the patient can be discharged home
*Consider repeat X-ray
*Consider admission or in house observation for asthmatics/COPD patients or those with continued symptoms after 4-6 hours

==See Also==

==External Links==

==References==
<references/>