Ammonium hydroxide

Definition 
This poisoning is from an exposure to ammonium hydroxide. It is found in many industrial solvents and cleaners.

Poisonous Ingredient 
Ammonium hydroxide (can also release ammonia gas into the air)

Where Found 

     
  • Ammonium hydroxide can be found in many industrial solvents and cleaners - hundreds to thousands of construction agents, flooring strippers, brick cleaners, cements, and many others.  
  • Ammonia alone (not ammonium hydroxide) can be found in many household cleaners. The symptoms and treatment for ammonia exposure are similar to those for ammonium hydroxide, and often the exposure is both ammonium hydroxide and ammonia released from the chemical as gas.

Note: This list may not be all inclusive.

Symptoms  

     
  • Respiratory       o Breathing difficulty (from inhalation)       o Throat swelling (which may also cause breathing difficulty)  
  • Eyes, ears, nose, and throat       o Severe pain in the throat       o Severe pain or burning in the nose, eyes, ears, lips, or tongue       o Loss of vision  
  • Gastrointestinal       o Severe Abdominal pain       o Vomiting       o Burns of the esophagus (food pipe)       o Vomiting blood       o Blood in the stool  
  • Heart and blood vessels       o Hypotension (Low Blood pressure) develops rapidly       o Collapse  
  • Skin       o Irritation       o Burn       o Necrosis (holes) in the skin or underlying tissues  
  • Blood       o Severe change in pH (too much or too little acid in the blood, which leads to damage in all of the body organs)

Home Treatment 
DO NOT INDUCE Vomiting.

If ammonium hydroxide is on the skin or in the eye, flush with lots of water for at least 15 minutes. If ammonium hydroxide was swallowed, give milk or water to dilute it. Fruit juices may also be given. If the person inhaled fumes, remove the patient to fresh air.

Before Calling Emergency 
Determine the following information:

     
  • The patient’s age, weight, and condition  
  • The name of the product (ingredients and strengths, if known)  
  • The time it was swallowed  
  • The amount swallowed

Poison Control, or a local emergency number 
Follow all instructions given to you by the poison control center. It is always necessary to seek medical attention for this type of exposure. Take the container with you to the emergency room. See poison control centers for the national toll-free poison hotline.

What to expect at the emergency room 
Some or all of the following procedures may be performed:

     
  • For swallowed poison       o Endoscopy - the placement of a camera down the throat to see the extent of burns to the esophagus and the stomach       o Give IV fluids       o Admission to the hospital       o Give an antidote       o Treat the symptoms  
  • For inhaled poisons       o A breathing tube may need to be inserted       o Oxygen       o Admission to the hospital or to the intensive care unit       o Bronchoscopy (inserting a camera down the throat into the airway to evaluate the extent of burns to the airway and lungs)  
  • For skin exposure       o Irrigation (washing of the skin), perhaps every few hours for several days       o Skin debridment (surgical removal of burned skin)       o Admission or transfer to a hospital that specializes in burn care

Expectations (prognosis) 

Survival past 48 hours usually indicates recovery will occur. If a chemical burn occurred in the eye, permanent Blindness will probably result. The prognosis (probable outcome) depends on how rapidly the alkali was diluted and neutralized.

Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible. The ultimate outcome depends on the extent of this damage. Damage continues to occur to the esophagus and stomach for several weeks after the alkali was swallowed, and death may occur as long as a month later.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.