title: Hydrochloric acid inhalation: who needs admission?
abstract: Nine pharmaceutical workers were exposed to hydrochloric acid (HCl) fumes. Four were discharged with no symptoms after a 4 h observation period in the accident and emergency (A&E) department. The remaining five were admitted to the medical unit because of severe symptoms, reduced peak expiratory flow rate (PEFR), or hypoxaemia. Treatment was symptomatic and discharge followed 24 h later. Only one patient, discharged from the medical unit, developed long term airway hyper-reactivity, superimposed on a background of chronic obstructive airways disease. Thus patients who are minimally symptomatic with normal PEFR and oxygen saturation values can be safely discharged from the A&E department after a short observation period of 4 h with advice to return if dyspnoea occurs. Caution should be employed in severely symptomatic patients, those with pre-existing lung pathology or reduced PEFR, and hypoxaemic patients, where observation for at least 24 h is recommended.
authors.affiliation: Accident and Emergency Department, Crosshouse Hospital, Kilmarnock, United Kingdom.
authors.forename: S H
authors.initials: SH
authors.lastname: Boyce
authors.forename: K A
authors.initials: KA
authors.lastname: Simpson
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D000403:Airway Resistance; D004345:Drug Industry; D004636:Emergency Service, Hospital; D006801:Humans; D006851:Hydrochloric Acid / Q000506:poisoning*; D000860:Hypoxia / Q000139:chemically induced; D001239:Inhalation; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000628:therapy*; D010343:Patient Admission; D010366:Peak Expiratory Flow Rate; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy
chemical_list: D000395:Air Pollutants, Occupational; D006851:Hydrochloric Acid