First Aid for Pool Chemical Exposure: A Narrative Review

Over 4500 visits to emergency departments related to pool chemical exposures occur annually in the United States, and it is likely that many more go unreported. Injury can occur due to sensitivity to standard chemical concentrations in pools (such as with opening one's eyes underwater), accidental exposure to super-concentrated chemicals (such as malfunction of a pool chlorinator), or accidental inhalation of fumes while opening the storage container for chlorination tablets. Therefore, first aid care has the potential to significantly limit morbidity.  A literature review was undertaken to determine the appropriate first aid for pool chemical exposures. This literature search revealed 25 pertinent articles, of which none were systematic reviews or studies directly related to the first aid treatment of pool chemical exposures. However, five articles were included as indirect evidence, and a hand search of references revealed five additional articles for inclusion. Treatment recommendations were extrapolated from the treatment of chemical exposures from other incidents. Symptoms of pool chemical exposure reflect irritation secondary to the caustic chemicals involved. Patients may report irritation of the skin, eyes, nose, or throat; cough; chest tightness; and difficulty breathing. Following any exposure to pool chemicals, the victim should be removed from the source, taken to an area with fresh air, and contaminated materials (e.g. clothing, contact lenses) should be removed. Irrigation of the exposed area should take place immediately with uncontaminated fresh water for at least 15 minutes. It is anticipated that an exposed person will be symptomatically improved by leaving the area of exposure, removing their contaminated clothing items, and irrigating the contaminated body parts. However, if symptoms do not resolve during that time or if symptoms are worsening, the victim should be evaluated by trained medical personnel.