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34 PAMPHLET 1 Delayed Effects A brief summary of key first aid points follows below. 7.2.1 Inhalation An individual with chlorine inhalation exposure should be evaluated by the first responder for adequate airway, breathing, and circulation. If the airway is obstructed remove the obstruction. If breathing has apparently ceased, the victim should be given cardiopulmonary resuscitation (CPR) immediately. If breathing has not ceased, the exposed individual should be placed in a comfortable position. In severe cases the person should lie down with the head and trunk elevated to a 45-60o position (unless there is a medical contraindication). Slow, deep breathing should be encouraged. Historically, oxygen therapy has been considered the primary treatment for chlorine inhalations. While it may not be necessary for all cases of chlorine inhalation, oxygen therapy is recommended in any case in which an individual continues to be symptomatic after leaving the area of exposure. Oxygen should be administered by first aid providers trained in the use of the specific oxygen equipment. Humidified oxygen is preferred since the humidity soothes the irritation to the mucous membranes, while oxygen without humidity can have a drying effect, potentially aggravating the irritant symptoms. However, oxygen without humidity should not be withheld if oxygen therapy is indicated. Suitable equipment for the administration of oxygen and personnel trained in the use of the equipment should be available either on-site or at a nearby facility. Such equipment should be periodically tested. The inhalation of any irritating gas may lead to delayed reactions, such as pulmonary edema. Since physical exercise appears to have some relation with the incidence of delayed reaction, it is recommended that any patient who has had a severe inhalation exposure should be kept at rest for a period of observation. Irritants (cigarette smoke, dust, etc.) should be avoided during this period of observation. The length of the period of observation will depend on the clinical assessment of the exposed individual. 7.2.2 Contact with Skin If liquid chlorine has contaminated the skin or clothing, an emergency shower should be used immediately and the contaminated clothing should be removed under the shower. Flush contaminated skin with copious amounts of tepid water for 15 minutes or longer. Do not attempt chemical neutralization or apply any salves or ointment to damaged skin. Refer to a qualified health care provider if irritation persists after irrigation or if skin is broken or blistered. 7.2.3 Contact with Eyes If eyes have been exposed to liquid chlorine or become severely irritated due to exposure to high concentration of chlorine gas they should be flushed immediately with copious amounts of tepid water for at least 15 minutes. Do not attempt to neutralize with chemical. The eyelids should be held apart to ensure water contacts all accessible tissue of the eyes and lids. Medical assistance must be obtained as soon as possible. IfPDF Image | Chlorine Basics 8
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