Ver el código de «Pulmonary chemical agents»

==Background==
*Include [[ammonia toxicity|ammonia]], [[methyl isocyanate]], [[methyl bromide]], [[hydrochloric acid]] and [[chlorine gas]], [[phosgene]]
*Common toxic industrial chemicals, transported widely across country
*Can affect central or peripheral airways
**burning and irritation to epithelial lining causing airway edema or [[pulmonary edema]], [[hypoxia]], and [[hypotension]]

===Pathophysiology===
*Choking agents combine with water in respiratory tract to form acids
*Both chlorine and phosgene react with water in respiratory tract to form hydrochloric acid

==Clinical Features==
Symptoms dependent on the water solubility of the chemical
*Highly water-soluble
**Anhydrous, ammonia, Hydrogen chloride, Sulfur dioxide, Formaldehyde
**Rapidly react with water causing damage to upper airway to vocal cords
**Direct tissue damage causing bronchiolar/alveolar edema/airway obstruction and laryngospasm
**Nasopharyngeal and tracheal [[chemical burns]], upper airway obstruction
**Laryngospasm (can occur immediately upon exposure)
**[[Respiratory distress]]/failure, [[hypoxia]]
**[[Cough]]
**[[Chest pain]]
**[[Arrhythmias]] (hydrochloric acid)
*Moderately water-soluble
**Damage to moderate-sized airways (bronchioles)
**Bronchospasm and wheezing
*Poorly water-soluble
**Phosgene, Nitrogen dioxide
**Inhaled deeply into alveoli
**Lack of irritation of mucous membranes can cause them to go undetected
**[[Respiratory distress]], tachypnea, [[cough]], [[pulmonary edema]]

==Differential Diagnosis==
{{Chemical weapon DDX}}

==Evaluation==

==Management==
*'''Decontaminate''' patient!
**Liquid phosgene can cause off-gassing with release of toxin from clothes post-exposure
*Do not allow patient to be active as it worsens condition
*Inhaled [[bronchodilators|beta agonists]] for bronchoconstriction
*Diuretics and corticosteroids ''not'' shown to be effective

==Disposition==

==See Also==
*[[Chemical weapons]]

==External Links==

==References==
<references/>

[[Category:Toxicology]]
[[Category:Pulmonary]]