Ammonium hydroxide poisoning
Aqueous - ammonia
Ammonium hydroxide is a colorless liquid chemical solution. It forms when ammonia dissolves in water. This article discusses poisoning from ammonium hydroxide.
This article is for information only. Do NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Poisonous Ingredient
Ammonium hydroxide is poisonous.
Where Found
Ammonium hydroxide is found in many industrial products and cleaners. Some of these are flooring strippers, brick cleaners, and cements.
Ammonium hydroxide can also release ammonia gas into the air.
Ammonia alone (not ammonium hydroxide) can be found in many household items such as detergents, stain removers, bleaches, and dyes. The symptoms and treatment for ammonia exposure are similar to those for ammonium hydroxide.
Other products may also contain ammonium hydroxide and ammonia.
Symptoms
Below are symptoms of ammonia poisoning in different parts of the body.
AIRWAYS AND LUNGS
- Breathing difficulty (if the ammonia is inhaled)
- Coughing
- Throat swelling (can also cause breathing difficulty)
- Wheezing
EYES, EARS, NOSE, AND THROAT
- Severe pain in the throat
- Severe pain or burning in the nose, eyes, ears, lips, or tongue
- Vision loss
ESOPHAGUS, STOMACH, AND INTESTINES
- Blood in the stool
- Burns of the esophagus (food pipe) and stomach
- Severe abdominal pain
- Vomiting, possibly with blood
HEART AND BLOOD
- Collapse
- Low blood pressure (develops rapidly)
- Severe change in pH (too much or too little acid in the blood, which leads to damage in all of the body organs)
SKIN
- Burns
- Holes in skin tissue
- Irritation
Home Care
Do NOT make the person throw up.
If ammonium hydroxide is on the skin or in the eyes, flush with lots of water for at least 15 minutes.
If the person swallowed ammonium hydroxide, give them milk or water right away. You may also give them fruit juice. But, DO NOT give anything to drink if they have symptoms that make it hard to swallow. These include vomiting, convulsions, or a decreased level of alertness.
If the person breathed in fumes, move them to fresh air right away.
Before Calling Emergency
Have this information ready:
- The person's age, weight, and condition
- The name of the product (ingredients and strength, if known)
- The time it was inhaled, swallowed, or touched the skin
- The amount inhaled, swallowed, or on the skin
Poison Control
Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions.
Local poison center
For a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...
This is a free and confidential service. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
Take the container with you to the hospital, if possible.
The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.
The person may receive:
- Breathing support, including tube through the mouth into the lungs, and breathing machine (ventilator)
- Blood and urine tests
-
Bronchoscopy
-- camera down the throat to see burns in the airways and lungs
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
- Chest x-ray
- EKG (heart tracing)
-
Endoscopy
-- camera down the throat to see burns in the esophagus and the stomach
Endoscopy
Endoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...
- Fluids through the vein (IV)
- Medicines to treat symptoms
- Surgery to remove burned skin
- Washing of the skin (irrigation), sometimes every few hours for several days
Some people may need to stay in the hospital overnight.
Outlook (Prognosis)
Survival past 48 hours usually means the person will recover. If the chemical burned their eye, permanent blindness will probably occur in that eye.
Chemical burned
Chemicals that touch skin can lead to a reaction on the skin, throughout the body, or both.
How well a person does depends on the strength of the chemical and how fast it was diluted and neutralized. Extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible.
The ultimate outcome depends on how severe the damage is. If the chemical was swallowed, damage to the esophagus and stomach continues to occur for several weeks, and death may occur weeks or months later.
References
Belson M. Ammonia and Nitrogen Oxides. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 97.
Harchelroad FP Jr, Rottinghaus DM. Chemical burns. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide . 6th ed. New York, NY: McGraw-Hill; 2004:chap 200.
Kleinschmidt K, Schwarz E. Toxic inhalants. In: Vincent J-L, Abraham E, Moore FA, Kochanek PM, Fink MP, eds. Textbook of Critical Care . 6th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 187.
Wax PM, Yarema M. Corrosives. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 98.
Wax PM, Young A. Caustics. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 153.
Review Date: 10/9/2015
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.