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    Chapter 11 Management of Hydrocarbon Poisoning

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    arief muhammad
    Hydrocarbons are organic compounds commonly found in industrial processes and household products that can cause poisoning if inhaled, ingested, or absorbed through the skin. Exposure leads to respiratory, neurological, gastrointestinal, and cardiac effects. Pulmonary toxicity from hydrocarbon aspiration can cause inflammation, hypoxia, and acute respiratory distress syndrome. Treatment involves maintaining an open airway, supplemental oxygen, securing the airway before gastric decontamination to prevent aspiration, and skin decontamination for cutaneous exposures. No antidotes exist, and steroids are not beneficial and may be harmful in some cases of hydrocarbon poisoning.

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    Chapter 11 Management of Hydrocarbon Poisoning

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    arief muhammad
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    Hydrocarbons are organic compounds commonly found in industrial processes and household products that can cause poisoning if inhaled, ingested, or absorbed through the skin. Exposure leads to respiratory, neurological, gastrointestinal, and cardiac effects. Pulmonary toxicity from hydrocarbon aspiration can cause inflammation, hypoxia, and acute respiratory distress syndrome. Treatment involves maintaining an open airway, supplemental oxygen, securing the airway before gastric decontamination to prevent aspiration, and skin decontamination for cutaneous exposures. No antidotes exist, and steroids are not beneficial and may be harmful in some cases of hydrocarbon poisoning.

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    Hydrocarbons are organic compounds commonly found in industrial processes and household products that can cause poisoning if inhaled, ingested, or absorbed through the skin. Exposure leads to respiratory, neurological, gastrointestinal, and cardiac effects. Pulmonary toxicity from hydrocarbon aspiration can cause inflammation, hypoxia, and acute respiratory distress syndrome. Treatment involves maintaining an open airway, supplemental oxygen, securing the airway before gastric decontamination to prevent aspiration, and skin decontamination for cutaneous exposures. No antidotes exist, and steroids are not beneficial and may be harmful in some cases of hydrocarbon poisoning.

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    Chapter 11 Management of Hydrocarbon Poisoning

    Uploaded by

    arief muhammad
    Hydrocarbons are organic compounds commonly found in industrial processes and household products that can cause poisoning if inhaled, ingested, or absorbed through the skin. Exposure leads to respiratory, neurological, gastrointestinal, and cardiac effects. Pulmonary toxicity from hydrocarbon aspiration can cause inflammation, hypoxia, and acute respiratory distress syndrome. Treatment involves maintaining an open airway, supplemental oxygen, securing the airway before gastric decontamination to prevent aspiration, and skin decontamination for cutaneous exposures. No antidotes exist, and steroids are not beneficial and may be harmful in some cases of hydrocarbon poisoning.

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    Chapter 11: Management of Hydrocarbon Poisoning

    Introduction

    Hydrocarbons are used in a wide variety of industrial processes. Examples of these organic compoiunds
    include gasoline, kerosene, lubricating oil, motor oil, mineral spirits, naphtha. Hydrocarbons may also be
    found as part of dry cleaning solutions, paint thinners, furniture polish, turpentine and other solvents..
    Some of these, especially organic solvents containing toluene, are abused by inhalation with much
    resulting euphoria for the abusers. A useful mnemonic for remembering such hydrocarbons is CHAMP:
    camphor, halogenated hydrocarbons, aromatic hydrocarbons, (heavy) metal-containing hydrocarbons,
    and pesticide-containing hydrocarbons. Most of the dangerous hydrocarbons are derived from
    petroleum distillates and include aliphatic hydrocarbons and aromatic hydrocarbons. Other
    hydrocarbons such as pine oil and turpentine are derived from wood.

    Types of exposure include unintentional ingestion, intentional recreational abuse, unintentional


    inhalation, and dermal exposure or oral ingestion in a suicide attempt. The highest rates of morbidity
    and mortality result from accidental ingestion by children younger than 5 years. Aspiration pneumonitis
    is the common complication of hydrocarbon ingestion, followed by CNS and cardiovascular effects.

    Pathophysiology

    The toxic potential of hydrocarbons is directly related to their physical properties. Highly volatile
    compounds with low viscosity are more likely to be inhaled or aspirated into the respiratory system.

    Pulmonary effects

    Pulmonary toxicity is the result of hydrocarbon aspiration. The result is often inflammation and
    bronchospasm. The volatile chemical may displace alveolar oxygen, leading to hypoxia. Direct toxic
    effects on the alveoli result in poor oxygen exchange, atelectasis, and pneumonitis. Respiratory
    symptoms generally begin in the first few hours after exposure and usually resolve in 2-8 days.
    Complications include hypoxia, barotrauma due to mechanical ventilation, and acute respiratory distress
    syndrome (ARDS). Prolonged hypoxia may result in encephalopathy, seizures, and death.

    Gastrointestinal effects

    Hydrocarbons cause irritation with abdominal pain, nausea and vomiting with possibility of aspiration.

    CNS effects

    This includes behavioural disinhibition similar to that seen in patients with alcohol intoxication. Narcosis
    and euphoria may also develop. Lethargy, headache, obtundation, and coma may follow. Seizures are
    uncommon and are likely to be due to hypoxia.

    Cardiac effects
    Dysrhythmias occur owing to hypoxia, myocardial sensitization to catecholamines, and direct myocardial
    damage. Sudden death rarely occurs from coronary vasospasm due to hydrocarbon inhalation.

    Other effects

    Bone marrow toxicity, hemolysis, liver and kidney failure have all been reported. Toluene, a major
    constituent of organic solvents, may cause renal tubular acidosis, local skin irritation and chemical burns.
    Most deaths from hydrocarbons occur in children younger than 5 years. Long-term exposure may result
    in cardiomyopathy, cerebellar atrophy, dementia, cognitive deficits, and peripheral neuropathy.

    Physical findings

    Hydrocarbon aspiration can elevate body temperature. Other findings at physical examination include:

    • Respiratory: Coughing, Choking, Fever, Tachypnea, Grunting, Cyanosis, Rales, and Wheezing.

    • CNS: Headache, Dizziness, Lethargy, Ataxia, Seizures, Coma

    • GI: Nausea, Vomiting, Abdominal pain

    • Cardiac: Arrhythmia

    • Skin: Mucosal irritation, Chemical burns

    Medical Care

    ABCs: Maintain an open airway. Give supplemental oxygen to all patients, and perform beside pulse
    oximetry. Early intubation, mechanical ventilation, and use of positive end-expiratory pressure may be
    warranted in patients in whom oxygenation is inadequate or in those with severe respiratory distress or
    decreased level of consciousness. Precautions to minimize the patient's risk of vomiting and further
    aspiration are important. In the presence of wheezing, a trial of bronchodilators may be warranted.

    Skin decontamination, if cutaneous exposure, must be carried out as soon as possible by removing
    clothing and thoroughly washing the skin with soap and water. Vapor inhalation and cutaneous
    absorption may occur long after the exposure.

    If gastric decontamination is considered, the airway must be secured to minimize risk of aspiration
    secondary to vomiting. Gastric decontamination is reserved only for large intentional ingestions. No
    specific antidotes are available for hydrocarbon poisoning. Treatment with corticosteroids and
    prophylactic antibiotics is not beneficial. In some cases, steroids may be harmful

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