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Pool Cleaner Toxicity - Chlorine Gas Exposure
The "shock" treatment that is utilized in pool cleaner is often contained in a large plastic container and is calcium hypochlorite. Chlorine gas accumulates in the small amount of airspace found in the container. If a future patient opens the container either in an enclosed space or within close proximity of the face that allows for large inhalational exposure.
- Toxicity looks like CHF with hypoxia, rales and acute lung injury on CxR
- Chlorine gas will bind hydrogen ion in the aveoli forming HCl - hydrochloric acid
- Nebulized NaHCO3 would theoretically neutralize this acid but has not been found to improve clinical outcome though it has been found to improve symptoms.
- Supportive care and observation including CxR 4-6 hours after exposure are necessary since the effects of the chlorine gas may be delayed.