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Irritant Gas Exposure, Emergency Medicine

Reviewed 06/2017



  • An irritant is any noncorrosive substance that on immediate, prolonged, or repeated contact with respiratory mucosa will induce a local inflammatory reaction.

  • Respiratory irritants ar...


Signs and Symptoms

  • Dependent on water solubility

  • Highly water-soluble gases:

    • Eye, nose, throat burning

    • Shortness of breath

    • Wheezing

    • Cough

    • Hoarseness

    • Stridor

    • Obstruction

  • Intermediate water solubility:

    • U...



Rescuer's goal is to prevent self-contamination with use of protective clothing or equipment (self-contained breathing apparatus). 

Initial Stabilization/Therapy

  • ABCs:

    • 100% oxygen t...



Admission Criteria

  • ICU admission:

    • Intubated patients

    • Significant respiratory insufficiency or potential upper airway obstruction

  • Persistently symptomatic with bronchospasm or oxygen r...

Pearls and Pitfalls

  • Beware of delayed onset of low-solubility agents. These exposures may require 23-hr observation for delayed respiratory symptoms.

  • Avoid exposure of agent to first responders, with a...

Additional Reading

  • Bosse  GM. Nebulized sodium bicarbonate in the treatment of chlorine gas inhalation. J Toxicol Clin Toxicol.  1994;32:233–241.

  • Rorison  DG, McPherson  SJ. Acute toxic inhalation...



  • 986 Toxic effect of carbon monoxide

  • 987.7 Toxic effect of hydrocyanic acid gas

  • 987.9 Toxic effect of unspecified gas, fume, or vapor

  • 987.8 Toxic effect of other specified gases, fumes, or vapor...

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