title: Chlorine and its impact on an emergency department.
abstract: BACKGROUND
  An incident involving the release of chlorine gas from the pump room at a local swimming pool resulted in 54 patients seeking treatment in the emergency departments (EDs) of two local, tertiary-level hospitals in Singapore. The hospital hazardous materials (HAZMAT) disaster plan was activated. This report describes how one of the EDs organized in response to the disaster.
  Of the 54 people seeking treatment, 36 were treated in the ED at the Singapore General Hospital. The patients were decontaminated at shower facilities prior to entering the ED. The ED was reorganized to cope with existing patients, as well as the large influx of patients from the event site. A protocol was established in coordination with the local drug and poison information center to manage the patients who suffered from chlorine inhalation. Most patients were observed in the ED and subsequently discharged. Outpatient review appointments were scheduled.
  Acute respiratory symptoms were the most common symptoms., Four children and four adults were admitted to the hospital, and the other patients were discharged from the ED after observation. All of the chest x-rays were normal on the day of the chlorine inhalation. There were no mortalities or significant morbidities, even up to six months after the incident.
  
  
  CONCLUSIONS
  Although this chlorine HAZMAT incident did not cause severe injuries, and only a limited number of persons required admission to the hospital, some valuable lessons were learned.
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, Singhealth, Singapore. Adeline_ngo@singhealth.com.sg
authors.forename: Adeline
authors.initials: A
authors.lastname: Ngo
authors.forename: R
authors.initials: R
authors.lastname: Ponampalam
authors.forename: Mark
authors.initials: M
authors.lastname: Leong
authors.forename: Lim Swee
authors.initials: LS
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002713:Chlorine / Q000009:adverse effects*; D003666:Decontamination; D004190:Disasters; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019982:Organizational Case Studies; D012128:Respiratory Distress Syndrome / Q000503:physiopathology; D012846:Singapore
chemical_list: D002713:Chlorine