From the Guidelines
Ammonia (NH3) inhalation can cause severe irritation and burns to the respiratory tract, eyes, and skin, and requires immediate medical attention. The effects of ammonia inhalation can be devastating, and it is essential to move the person to fresh air immediately and call emergency services 1. While waiting for help, keeping the person comfortable, loosening tight clothing, and monitoring their breathing is crucial. According to the study published in the World Journal of Emergency Surgery 1, ingestion of ammonia can result in superficial hemorrhagic gastritis, which may progress during the first 24–48 hours and requires specific surveillance.
Key Considerations
- Ammonia is a caustic chemical that can cause severe irritation and burns to the respiratory tract, eyes, and skin 1.
- The severity of symptoms depends on the concentration and duration of exposure, ranging from mild irritation to severe respiratory distress.
- Concomitant vapor aspiration of ammonia may cause airway burns 1.
- Caregivers should be aware that specific corrosives, including ammonia, may also cause severe systemic effects such as hypocalcemia, hyponatremia, hypokalemia, and acidosis 1.
Management
- For mild exposure with minor irritation, breathing fresh air may be sufficient.
- More severe exposures may require oxygen therapy or other medical interventions that will be administered by healthcare professionals.
- Do not induce vomiting if ammonia was also ingested, as this can cause further damage to the esophagus and stomach 1.
- Long-term effects may include chronic respiratory issues, so proper medical follow-up is essential even after initial recovery.
From the Research
Effects of Ammonia Inhalation
The effects of ammonia (NH3) inhalation can be severe and varied, depending on the level and duration of exposure 2, 3, 4, 5, 6.
- Ammonia is a highly toxic irritant gas that can cause tissue damage via exothermic reaction with body tissues, leading to liquefactive necrosis 2.
- Inhalation of ammonia can result in upper airway and bronchoalveolar injury, and even fatal inhalation of anhydrous ammonia has occurred 3.
- The symptoms of ammonia inhalation can range from mild to severe life-threatening respiratory distress and neurological deterioration, including upper airway edema, pulmonary edema, and pneumothorax 2, 4.
- Chronic lung disease can also occur secondary to ammonia inhalation injury, including restrictive lung dysfunction, obstructive lung disease, and bronchial hyper-reactivity 6.
Management and Treatment
The management of ammonia inhalation is supportive, and there is no available antidote 2.
- Treatment may involve respiratory support, inhaled steroids and bronchodilators, antibiotics, electrolyte replacement, analgesics, and supportive eye and oral treatments 2.
- In severe cases, extracorporeal membrane oxygenation (ECMO) may be used in combination with other critical technologies to treat acute severe ammonia-induced intoxication 4.
- A multi-disciplinary approach and prompt management are crucial in the treatment of ammonia toxicity, and raising awareness regarding the work environment and timely recognition of possible occupational health hazards is important 2.