Makarovsky Igor, Markel Gal, Dushnitsky Tsvika, Eisenkraft Arik
CBRN Medicine Branch, Medical Corps, Israel Defense Force, Israel.
Isr Med Assoc J. 2008 Jul;10(7):537-43.
Ammonia is a common household and industrial chemical. In the medical literature and the electronic press there are many descriptions of accidental spills of anhydrous ammonia, but apart from the Chechen war, there is no evidence of its intentional use by a terrorist to date. When considering its characteristics, ammonia tankers may pose an imminent threat for a civilian population nearby. This short review attempts to highlight the main health issues and basic principles of medical management after exposure to ammonia. Ammonia can directly cause damage due to its irritating as well as alkaline properties. The management of toxic exposure to ammonia is largely supportive and there is no specific antidote. Emergency medical response on site includes rapid evacuation, life-saving procedures and decontamination if necessary and if possible. Major clinical manifestations include respiratory symptoms, such as hypoxia, bronchospasm and pulmonary edema, as well as hypovolemia and burns to the skin and eyes. The immediate medical management consists of life-saving procedures and supportive care, while broad-range antibiotics and systemic corticosteroids may have a role in preventing late onset complications.
氨是一种常见的家用和工业化学品。在医学文献和电子媒体中，有许多关于无水氨意外泄漏的描述，但除了车臣战争外，迄今为止尚无证据表明恐怖分子曾故意使用氨。考虑到其特性，液氨运输船可能会对附近平民构成紧迫威胁。这篇简短综述试图突出接触氨后的主要健康问题及医疗处理的基本原则。氨因其刺激性和碱性可直接造成损害。氨中毒的处理主要是支持性治疗，且没有特效解毒剂。现场紧急医疗应对措施包括迅速疏散、实施救生程序以及必要且可能时进行去污处理。主要临床表现包括呼吸系统症状，如缺氧、支气管痉挛和肺水肿，以及低血容量和皮肤与眼部烧伤。即时医疗处理包括救生程序和支持性护理，而广谱抗生素和全身性皮质类固醇可能在预防迟发性并发症方面发挥作用。
