Inhalation of ammonia vapour. A report on the management of eight patients during the acute stages.

Eight men were admitted to hospital following exposure to gaseous ammonia at a local factory. They were divided into three groups, according to their clinical condition. The clinical findings, chest radiographs and treatment are discussed. One case was very severely injured. His management is discussed in detail. He required mechanical ventilation, positive end expiratory pressure and tracheostomy. The toxic effects of ammonia gas are discussed. A review of the literature is included. It was concluded that ammonia is an extremely irritant gas, capable of producing severe damage to all levels of the respiratory tract which may result in clinical impairment of respiratory function, ranging from mild to fatal. Prolonged respiratory support may be required. Superinfection may cause a late deterioration in those severely affected.