Water is the most important emergency treatment given for anhydrous ammonia exposures before advanced medical services arrive.
Anhydrous ammonia is hydrophilic which is to say it has a strong affinity for water. When anhydrous ammonia vapor or liquid comes in contact with water it forms the corrosive alkaline ammonium hydroxide.
The human body consists of 70% water by weight. Our eyes and lungs contain much more water than this rendering our vision (eyes) and breathing (respiratory system) especially at risk to the hazards of ammonia exposure.
When anhydrous ammonia gas or liquid comes in contact with the human body three types of injuries may result:
There is no antidote for ammonia poisoning. First aid consists of decontamination, maintaining open airway, and respiration support followed by rapid transport to an advanced medical care facility. After decontamination no special protective clothing is required for those caring for the injured.
Be aware that children are much more vulnerable to ammonia injury because of their larger surface area to body weight ratio. Also, a child's respiratory system will suffer the affects of ammonia exposure more so than an adult because children have a greater lung surface area relative to their body weight.
Rescuers need to be trained on scene safety and attired in proper personal protective clothing which should include self contained breathing apparatus (SCBA) to prevent themselves from becoming casualties. Ample quantities of fresh water must be available. If the ammonia release hasn't been controlled, remove patient from the “hot zone” and rapidly decontaminate with water according to the following guidelines:
Eye Contact: The extent of eye injury is dependent upon the duration of the exposure and concentration of the gas or liquid. Even low air ammonia concentrations can be very irritating to the eyes. Permanent eye damage is not unlikely. Contact lenses should never be worn when working with ammonia.
Skin Contact: Ammonia gas may cause skin irritation especially where skin is moist (perspiration). Patients exposed to only ammonia gas and have no skin or eye irritation do not need decontamination. Ammonia liquid will cause extensive skin damage resulting from dehydration, freezing and the corrosive action of ammonium hydroxide.
Inhalation: Even at low concentrations ammonia vapor is very irritating to the nose, mouth, throat and lungs. The airway may swell and constrict making respirations difficult for those exposed. Because of a child's narrow airway they are especially susceptible to breathing difficulties if exposed.
Ingestion: Ingestion of anhydrous ammonia is rare. Ingestion of the liquid may result in severe irritation or corrosive damage of the mouth, throat and stomach which may be displayed by nausea, vomiting, diarrhea, and in severe cases, collapse, shock and death. Ingestion of ammonia does not normally result in systemic poisoning.
Permanent ammonia storage locations are required to have an open container filled with water for emergency use.
Each ammonia nurse tank has a water supply designed to provide ready access for flushing any part of the body contacted by ammonia.