UMEM Educational Pearls

Category: Toxicology

Title: Summer is Coming - Toxicity from around the Pool

Keywords: chlorine, pneumonitis (PubMed Search)

Posted: 5/22/2008 by Fermin Barrueto, MD (Updated: 10/21/2021)
Click here to contact Fermin Barrueto, MD

Pool Cleaner Toxicity - Chlorine Gas Exposure 

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.