Chlorine gas induced acute respiratory distress syndrome due to pool shock

Chlorine gas is a known pulmonary irritant with potential to cause significant lung injury. Most severe cases stem from industrial accidents or chemical warfare, and while exposure is common with chlorinated household cleaners, life threatening events are rare. A 75-year-old male developed acute respiratory distress syndrome (ARDS) following an accidental chlorine exposure after mixing calcium hypochlorite powder with water in his sink, triggering an explosion with chlorine gas release. He rapidly developed bronchospasm, pulmonary edema and respiratory failure within hours of exposure, in addition to severe chemical conjunctivitis. He was rapidly intubated, received bronchodilators, intravenous dexamethasone and inhaled epoprostenol, and underwent prone positioning. Targeted therapy for chlorine gas induced lung injury is limited. Despite a rapid decline over his initial clinical course, and prognostic markers all portending a poor outcome, aggressive management of his lung injury with standard ARDS care proved to be effective, and the patient made an excellent recovery.