Ammonia

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					Ammonia (NH3)
     Ammonia (NH3)
• Naturally occurring compound
      Ammonia (NH3)
• Naturally occurring compound
• Essential in biological processes
      Ammonia (NH3)
• Naturally occurring compound
• Essential in biological processes
• Nutrient for bacteria and plants
      Ammonia - Overview
• Physical properties
  •   Very distinct, sharp odor
  •   Colorless gas
  •   Evaporates quickly
  •   Readily dissolves in water
  •   Somewhat flammable at concentrations of
      15 to 25% by volume in air
• Low odor threshold of 5 ppm
• Causes eye irritation at 20 ppm
       Ammonia - Overview
   Widely available
   Easily obtained in a variety of commercial and
    home compounds
   Useful to terrorists seeking to disable groups of
    people rather than killing them
         Ammonia - Toxicity
   Natural substance
       Any environmental release > 100 lbs of
        ammonia or 1,000 lbs of ammonium salts must
        be reported to the EPA
       OSHA limit: 50 ppm over an 8-hour workday,
        40-hour workweek
       NIOSH limit: 25 ppm ammonia averaged over
        an 10-hour workday or 40-hour workweek
          Ammonia - Toxicity
   Prolonged exposure to concentrations > 300
    ppm can cause permanent injury or death

   Major route of toxicity is inhalation

   Children may be more vulnerable than adults
     Protective Equipment
   Variety of rubber and plastic materials

   Wear protective clothing appropriate to the
    type and degree of contamination

   Use a positive-pressure, self-contained
    breathing apparatus (SCBA)

   Rescue vehicles should carry ammonia-
    resistant plastic sheeting and disposable
    bags
               Detection
   Distinctive odor

   Variety of monitors and gas sensors for
    water or air available commercially
         Decontamination
   Move victims into an area of fresh air

   Remove and double-bag contaminated
    clothing and personal belongings
           Decontamination
   Eye exposure
       Flush the eyes with lukewarm water or saline
        for a minimum of 15 minutes
       Contact lenses should be removed
           Decontamination
   Skin exposure
       Flush skin and hair with plain water for 5
        minutes
       Wash with soap and water and rinse
        thoroughly
           Decontamination
   Ingestion
       Give 4 to 8 ounces of water or milk
       Do not induce emesis, perform gastric lavage,
        attempt neutralization, or administer
        activated charcoal
        Signs and Symptoms
   Diagnosis is mainly a clinical one
   Skin and Eyes
       Extent of injury depends on the duration and
        concentration of the exposure
       Low concentration (5%) exposures are
        irritating but rarely damaging
       Concentrated (25%+) solutions or vapors can
        cause significant injury
       Frostbite injury can result from liquefied
        ammonia
        Signs and Symptoms
   Gastrointestinal
       Not common, but possible in the form of
        ammonium hydroxide
       Will produce nausea, vomiting, and abdominal
        pain
       Serious burns of the mouth, pharynx,
        esophagus, and stomach at concentrations of
        10% and higher
        Signs and Symptoms
   Respiratory System
       Low concentrations (20 to 100 ppm)
           Eye and nasal irritation, sore throat, lacrimation,
            rhinorrhea, and coughing
       Higher concentrations (>100 ppm)
           Nasopharyngeal and tracheal burns, bronchiolar
            and alveolar edema, and airway destruction
       Symptomatic patients should be hospitalized
        and observed until symptom-free
        Signs and Symptoms
   Cardiovascular
       Hypertension has been reported and can
        reach malignant levels
       Myocardial infarction and cardiac death have
        followed ammonia exposure
                 Treatment
   Basic first aid for victims

   ALS protocols
       Comatose, hypotensive, having seizures or
        who have cardiac arrhythmias


   No specific treatment for and care is
    primarily supportive
                 Treatment
   Eyes
       Test visual acuity, check for corneal damage,
        and treat appropriately
       Severe corneal injuries require urgent
        consultation by an ophthalmologist
       Minor injuries should be re-examined by an
        ophthalmologist within 24 hours
                       Treatment
   Skin
       Treat as thermal burns
       Frostbite injuries
           Rewarm affected areas in a water bath
                Temperature of 102° to 108° F (40° to 42° C)
                20 to 30 minutes and
                Continue until a red / pink flush has returned
                 Treatment
   Cardiopulmonary
       At first sign of airway compromise, secure the
        airway and maintain ventilation
       Administer supplemental oxygen by mask
       Observe patients for 6 - 12 hours for signs of
        upper-airway obstruction and pulmonary
        edema
       For bronchospasm: aerosolized
        bronchodilators
       For children with stridor: aerosolized
        epinephrine
       Treat hypertension medically and monitor for
        cardiac injury
Long-Term Medical Sequelae
    Severe inhalation injury
        Residual bronchoconstriction,
         bronchiectasis, small airway disease, and
         chronic lung disease
    Eye injuries
        Ulceration and perforation of the cornea can
         develop weeks or even months after exposure
    Permanent blindness, cataracts and
     glaucoma also possible
Long-Term Medical Sequelae
    Ingestion injuries
        Permanent damage to the mucous
         membranes of the alimentary canal
        Bleeding, perforation, scarring, or stricture
         formation as potential sequelae

    Reproductive, carcinogenic, and
     teratogenic effects of ammonia are not
     known
    Environmental Sequelae
   Naturally occurring
       Taken up from soil and water by plants and
        bacteria to be recycled naturally as part of
        the nitrogen cycle
   Environmental damage
       Overgrowth of aquatic plants and the
        depletion of oxygen in the water
       Corrosive effects of ammonium hydroxide
                  Summary
   High potential for terrorist use because it is
    readily and commercially available
   Low concentrations (20 - 100 ppm)
       Skin and eye irritation

   Higher concentrations
       Dermal burns
       Nasopharyngeal and tracheal burns
       Bronchiolar and alveolar edema
       Airway destruction resulting in respiratory
        distress or failure
                 Summary
   Prolonged exposure to concentrations >
    300 ppm
       Permanent injury or death

   Decontamination and basic first aid are
    critical
   No specific treatment and care is primarily
    supportive
       Standard ALS protocols when indicated

				
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