Pascuzzi T A, Storrow A B
Joint Military Medical Centers Emergency Medicine Residency, Wilford Hall and Brooke Army Medical Centers, San Antonio, TX 78236, USA.
Mil Med. 1998 Feb;163(2):102-4.
Mass exposure to chloramine gas has not been reported. We report two groups of 36 patients (72 total) suffering from acute inhalation of chloramine gas. Chloramine gas is produced from mixing common household cleaning agents containing sodium hypochlorite (bleach) and ammonia. The first mass casualty event occurred when 36 male soldiers were exposed during a "cleaning party" in their barracks. Ten days later, 36 female soldiers were exposed in a similar manner and presented to our emergency department. In each event, commonly available cleaning agents--liquid bleach and ammonia--were mixed together, liberating toxic chloramine gas. Nebulized sodium bicarbonate solution has been suggested for treatment of chlorine gas inhalation, but no report of nebulized sodium bicarbonate for treatment of chloramine gas inhalation injury exists. In our series, 22 patients exposed to chloramine gas were treated with a nebulized solution of 3.75% sodium bicarbonate. This treatment made no significant statistical or clinical difference in outcome. We present the largest case series of patients presenting to an emergency department for treatment of acute inhalation of chloramine gas.
尚未有大规模接触氯胺气体的报道。我们报告了两组共36名（总计72名）因急性吸入氯胺气体而患病的患者。氯胺气体是由混合含有次氯酸钠（漂白剂）和氨的普通家用清洁剂产生的。第一起大规模伤亡事件发生在36名男士兵在营房的“清洁活动”中接触到氯胺气体。十天后，36名女士兵以类似方式接触到氯胺气体并被送往我们的急诊科。在每起事件中，常见的清洁剂——液体漂白剂和氨——被混合在一起，释放出有毒的氯胺气体。有人建议用雾化碳酸氢钠溶液治疗氯气吸入，但尚无关于雾化碳酸氢钠治疗氯胺气体吸入损伤的报道。在我们的病例系列中，22名接触氯胺气体的患者接受了3.75%碳酸氢钠雾化溶液的治疗。这种治疗在结果上没有显著的统计学或临床差异。我们呈现了因急性吸入氯胺气体而到急诊科治疗的患者中最大的病例系列。
