NEBULIZED SODIUM-BICARBONATE IN THE TREATMENT OF CHLORINE GAS INHALATION

In this two year retrospective review, 86 cases of chlorine gas inhala tion from 49 medical facilities were treated with nebulized sodium bic arbonate on the recommendation of the Kentucky Regional Poison Center. Typical manifestations included cough, chest discomfort, shortness of breath, and wheezing. No patients developed pulmonary edema or respir atory insufficiency requiring ventilatory support. Sixty-three cases ( 73.3%) were exposures to chlorine producing acid/hypochlorite mixtures . Six (7.0%) were exposed to chlorine gas in industrial settings. Twel ve (14.0%) were exposed to chlorine gas in swimming pool settings. Six ty-nine (80.2%) were treated and released from the emergency departmen t. In 53 patients, clinical condition was clearly improved on emergenc y department discharge. Seventeen (19.8%) were admitted to the hospita l. All admitted patients gradually improved and had a mean hospital st ay of 1.4 days (range 1 to 3 days). No patients in this study deterior ated clinically after nebulized sodium bicarbonate use. Nebulized sodi um bicarbonate appears safe and merits prospective evaluation in the t herapy of chlorine gas inhalation.