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.
