Swimming pool cleaner poisoning: MedlinePlus Medical Encyclopedia

P Swimming pool cleaner poisoning occurs when someone swallows this type of cleaner, touches it, or breathes in its fumes. These cleaners contain chlorine and acids. Chlorine is more likely than the acids to cause serious poisoning.
P 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.

T Poisonous Ingredient
P The harmful substances in swimming pool cleaner are:
- Bromine
- Calcium chloride
- Calcium hypochlorite
- Chelated copper
- Chlorine
- Soda ash
- Sodium bicarbonate
- Various mild acids

T Where Found
P Various swimming pool cleaners contain these substances.

T Symptoms
P Below are symptoms of swimming pool cleaner poisoning in different parts of the body.
P EYES, EARS, NOSE, AND THROAT
- Loss of vision
- Severe pain in the throat
- Severe pain or burning in the nose, eyes, ears, lips, or tongue
P STOMACH AND INTESTINES
- Blood in the stool
- Burns of the food pipe (esophagus)
- Severe abdominal pain
- Nausea
- Vomiting (may contain blood)
P HEART AND BLOOD
- Collapse
- Low blood pressure that develops rapidly
- Too much or too little acid in the blood -- leads to organ damage
P LUNGS AND AIRWAYS
- Breathing difficulty (from breathing in the substance)
- Throat swelling (may also cause breathing difficulty)
P SKIN
- Burn
- Holes in the skin or tissues under the skin
- Irritation

T Home Care
P Get medical help right away. Do NOT make the person throw up unless poison control or a health care provider tells you to.
P If the cleaner is on the skin or in the eyes, flush with lots of water for at least 15 minutes.
P If the person swallowed the cleaner, give them water or milk right away, if a provider tells you to do so. Do NOT give anything to drink if the person has symptoms that make it hard to swallow. These include vomiting, convulsions, or a decreased level of alertness.
P If the person breathed in fumes of the cleaner, move them to fresh air right away.

T Before Calling Emergency
P Have this information ready:
- Person's age, weight, and condition
- Name of the product (and ingredients, if known)
- Time it was swallowed
- Amount swallowed

T Poison Control
P 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 national hotline number will let you talk to experts in poisoning. They will give you further instructions.
P This is a free and confidential service. All local poison control centers in the United States use this national number. 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.

T What to Expect at the Emergency Room
P Take the container with you to the hospital, if possible.
P The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.
P The person may receive:
- Breathing support, including tube through the mouth into the lungs, and breathing machine (ventilator)
- Bronchoscopy: camera down the throat to see burns in the airways and lungs
- Chest x-ray
- EKG (electrocardiogram), or heart tracing
- Endoscopy: camera down the throat to see burns in the esophagus and the stomach
- Fluids through a vein (by IV)
- Surgery to remove burned skin
- Tube through the mouth into the stomach to wash out the stomach (gastric lavage)
- Washing of the skin (irrigation), perhaps every few hours for several days

T Outlook (Prognosis)
P How well someone does depends on how severe their poisoning is and how quickly they receive treatment. The faster medical help is given, the better the chance for recovery.
P High doses of chlorine and swimming pool cleaning acids can be very poisonous. Serious damage to the mouth, throat, and stomach is possible. The outcome will depend on the extent of this damage.
P Opening a large bucket of chlorine tablets can expose you to a powerful chlorine gas that can be very poisonous. Always open the container outdoors. Keep your face as far away from the open container as possible.

T References
P 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.
P Nelson LS, Hoffman RS. Inhaled toxins. 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 159.
P 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.
P Zosel AE. General approach to the poisoned patient. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 143.

T Review Date 11/4/2015
P Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

