Irritant gas poisoning - Chlorine, formol, ammonia, hydrogen sulphide, etc.

Irritant gases are those that are characterised by their effect on the airway.

Their irritant action is at the level of the respiratory tree and on the rest of the mucous membranes with which they come into contact. Intoxication is produced by accidental exposure to the toxicant or for self-inflicted self-injury.

The main consequence of exposure is acute respiratory failure, bluish discolouration of the skin (cyanosis), elevated respiratory and heart rate (tachypnoea and tachycardia), sweating and pallor. Other symptoms may include lacrimation, rhinorrhoea, sneezing, dry irritative cough and laryngeal stridor that can lead to death by asphyxia, cardiac alterations such as arrhythmias and heart failure, neurological involvement with convulsions and coma, gastric alteration with bleeding, pain, and cutaneous lesions with redness, inflammation, followed by whitish pasty lesions, vesicles, ulceration and finally tissue loss.

Diagnosis requires clinical suspicion and a complete physical examination, as the diagnosis of certainty is made late. General laboratory tests, chest X-ray and electrocardiogram should be requested.

It is important to take basic measures to protect the airway, resuscitate and correct vital signs. Treatment is symptomatic, with symptom support depending on the organs and systems affected.