Authors: MD Zeus Paolo Enriquez Rapada , MD, FPCEM, MMHoA Amado A. Flores III

Abstract

Background: Inhalational injury secondary oxalic acid and chlorine, individually, is uncommon and combination of the two is rare. Injuries from both agents are from accidental ingestion or inhalation and attempt to self-harm.

Objectives: We present patients exposed to oxalic and chlorine gasses and seen at the emergency department, the adverse reactions related to the time of exposure, abnormalities in the diagnostic exams, and management.

Case Series Presentation:  A total of six patients were seen in this study. Patients exposed within 2 minutes to 10 minutes experienced difficulty of breathing, non-productive cough, sore throat, shortness of breath, throat itchiness. However, there was noted vomiting for a patient who was exposed for 15 minutes. There were no noted significant changes on complete blood count, electrolytes, 12 lead electrocardiograph and chest radiograph with one exception. There was an incidental finding of pneumonia in one of the patients. Conservative treatment was given to all patients including IV hydration, steroid therapy, oxygen supplementation and IV proton pump inhibitor (PPI). All patients were discharged after treatment and observation in the Emergency Department.

Conclusion: Hazardous effects of the inhalation of oxalic acid and chlorine were seen in patients, manifesting with respiratory symptoms. Length of exposure may be a factor in the severity of the symptoms. Rare cases of inhalational injury from both agents can be managed conservatively.

Keywords: Inhalational Injury, Oxalic Acid, Chlorine Exposure