Clinical Spectrum of Acute Chlorine Poisoning in Children

Öz

Objective: Chlorine gas (Cl2) is a common substance used in industry, which causes toxic inhalation as a potent pulmonary irritant. Herein, we aimed to investigate the findings of pediatric cases accidentally exposed to Cl2 gas.

Material and Methods: In October 2017, an accident involving Cl2 gas exposure occurred in a school where 650 students were trained.

Results: Fifty students breathed in the steam generated in the school hallway as a result of an accident during cleaning The mean age of the patients was 11.2±1.5 years (range 2–18 years); 62% of the children were male. Among patients evaluated at the emergency department, 21 (42%) patients were discharged within 4-6 hours after the initial examination and symptomatic treatment. The remaining 29 patients were hospitalized. The presenting symptoms were mostly associated with one another, which included cough and dyspnea (n=30, 60%), nausea and vomiting (n=6, 12%), headache (n=7, 14%), and sore throat (n=3, 6%). Thirty patients had elevated creatine kinase-MB (CK-MB) (mean 54.9±50.1 U/L). Five patients had sinus tachycardia on electrocardiogram. During the follow-up period, cardiac enzymes of all patients returned to normal levels. Seven patients were treated with steroids, bronchodilators, and humidified oxygen; 11 patients were treated with oxygen and bronchodilators; the remainders took oxygen alone.

Conclusion: We suggest that this study will contribute to raising awareness about chemicals that can produce toxic substances, as in our cases.

Anahtar Kelimeler

• Bleach
• hydrochloric acid
• chlorine gas
• pediatric

Çocuklarda Akut Klor Zehirlenmesinin Klinik Spektrumu

Öz

Amaç: Klor gazı endüstride yaygın olarak kullanılan ve akciğerlerde güçlü bir tahriş edici olarak inhalasyon toksisitesine neden olan bir maddedir. Bu çalışmada kaza ile klor gazına maruz kalan çocuk olguların bulgularını incelemeyi amaçladık.

Gereç ve Yöntemler: Ekim 2017’de, 650 öğrencinin eğitim aldığı bir okulda Cl2 gazına maruz kalmayı içeren bir kaza meydana geldi.

Bulgular: Elli öğrenci temizlik sırasında meydana gelen bir kaza sonucu okul koridorunda oluşan buharı teneffüs etti. Ortalama yaşları 11.2±1.5 yıl (dağılım 2-18 yıl) olan çocukların %62’si erkekti. Acil serviste değerlendirilen hastalardan 21’i (%42) ilk muayene ve semptomatik tedaviden sonra 4-6 saat içinde taburcu edildi. Kalan 29 hasta hastaneye yatırıldı. Çoğunlukla birbirleriyle benzer olan başvuru semptomları; öksürük ve nefes darlığı (n=30, %60), bulantı ve kusma (n=6, %12), baş ağrısı (n=7, %14) ve boğaz ağrısı ( n=3, %6)’di. Otuz hastada yüksek kreatin kinaz-MB (CK-MB) vardı (ortalama 54.9±50.1 U/L); beş hastanın elektrokardiografisinde sinüs taşikardisi vardı. Takip süresi boyunca tüm hastaların kardiyak enzimleri normale döndü. Yedi hasta steroid, bronkodilatör ve nemlendirilmiş oksijen ile tedavi edildi; 11 hasta oksijen ve bronkodilatör ile tedavi edildi; kalanlar yalnızca oksijen aldı.

Sonuç: Bu çalışmanın, bizim vakalarımızdaki gibi toksik maddeler üretebilecek kimyasallar hakkında farkındalığının artırılmasına katkı sağlayacağını düşünüyoruz.

Anahtar Kelimeler

• çamaşır suyu
• hidroklorik asit
• klor gazı
• pediatrik

Kaynakça

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