RT Journal Article SR Electronic T1 Hydrochloric acid inhalation: who needs admission? JF Journal of Accident & Emergency Medicine JO Arch Emerg Med FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine SP 422 OP 424 DO 10.1136/emj.13.6.422 VO 13 IS 6 A1 Boyce, S H A1 Simpson, K A YR 1996 UL http://emj.bmj.com/content/13/6/422.abstract AB Nine pharmaceutical workers were exposed to hydrochloric acid (HCl) fumes. Four were discharged with no symptoms after a 4 h observation period in the accident and emergency (A&E) department. The remaining five were admitted to the medical unit because of severe symptoms, reduced peak expiratory flow rate (PEFR), or hypoxaemia. Treatment was symptomatic and discharge followed 24 h later. Only one patient, discharged from the medical unit, developed long term airway hyper-reactivity, superimposed on a background of chronic obstructive airways disease. Thus patients who are minimally symptomatic with normal PEFR and oxygen saturation values can be safely discharged from the A&E department after a short observation period of 4 h with advice to return if dyspnoea occurs. Caution should be employed in severely symptomatic patients, those with pre-existing lung pathology or reduced PEFR, and hypoxaemic patients, where observation for at least 24 h is recommended.