Occupational Asthma Reference

Boyce SH, Simpson KA, Hydrochloric acid inhalation: who needs admission?, J Accid Emerg Med, 1996;13:422-424,

Keywords: acute lung injury, hydrochloric acid, UK, Scotland,

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Abstract

Nine pharmaceutical workers were exposed to hydrochloric acid (HCI) fumes. Four were discharged with no symptoms after a 4 h observation period in the accident and emergency (A&E) department. The remaining five were admitted to the medical unit because of severe symptoms, reduced peak expiratory flow rate (PEFR), or hypoxaemia. Treatment was symptomatic and discharge followed 24 h later. Only one patient, discharged from the medical unit, developed long term airway hyper-reactivity, superimposed on a background of chronic obstructive airways disease. Thus patients who are minimally symptomatic with normal PEFR and oxygen saturation values can be safely
discharged from the A&E department after a short observation period of 4 h with
advice to return if dyspnoea occurs. Caution should be employed in severely symptomatic patients, those with pre-existing lung pathology or reduced PEFR, and hypoxaemic patients, where observation for at least 24 h is recommended

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