Hydrocarbons Toxicity Workup

  • Author: Randy J Goldstein, MD; Chief Editor: Timothy E Corden, MD   more...
 
Updated: Nov 21, 2011
 

Laboratory Studies

  • ABG assessment
    • ABG analysis is useful in documenting hypoxemia in severely affected patients.
    • Hypercarbia may be observed in patients with respiratory depression and decreased gas exchange.
  • Serum chemical tests
    • In the acute phase, serum chemical results are expected to be within the normal ranges.
    • An increased anion gap may indicate co-ingestion of another toxin.
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Imaging Studies

  • Chest radiography
    • A chest radiograph must be obtained in all symptomatic patients.
    • Initially, the chest radiographic results may be normal, but positive findings may develop over the first few hours after ingestion (see image below).Hydrocarbon pneumonitis. Hydrocarbon pneumonitis.
  • Common findings include fine perihilar opacities, bibasilar infiltrates, and atelectasis.
    • Obtain repeat radiographs if any acute change in the patient's respiratory status occurs because a pneumothorax or pneumomediastinum may develop.
    • If discharge is being considered for an asymptomatic patient, a chest radiograph should be obtained 6 hours after the ingestion to document the negative findings.
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Other Tests

  • Bedside pulse oximetry is useful in the emergency department because hypoxia is a direct result of hydrocarbon aspiration.
  • Obtain an ECG if cardiac arrhythmia is a concern.
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Contributor Information and Disclosures
Author

Randy J Goldstein, MD  Emergency Department Medical Director, Las Palmas Medical Center

Randy J Goldstein, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

William T Zempsky, MD  Associate Director, Assistant Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Connecticut and Connecticut Children's Medical Center

William T Zempsky, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD  Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Merck Salary Employment

Paul D Petry, DO, FACOP, FAAP  Consulting Staff, Freeman Pediatric Care, Freeman Health System

Paul D Petry, DO, FACOP, FAAP is a member of the following medical societies: American Academy of Osteopathy, American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Chief Editor

Timothy E Corden, MD  Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, and Wisconsin Medical Society

Disclosure: Nothing to disclose.

References

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  2. Hesterberg TW, Long CM, Sax SN, Lapin CA, McClellan RO, Bunn WB, et al. Particulate matter in new technology diesel exhaust (NTDE) is quantitatively and qualitatively very different from that found in traditional diesel exhaust (TDE). J Air Waste Manag Assoc. Sep 2011;61(9):894-913. [Medline].

  3. Birch ME. Exposure and Emissions Monitoring during Carbon Nanofiber Production--Part II: Polycyclic Aromatic Hydrocarbons. Ann Occup Hyg. Nov 2011;55(9):1037-47. [Medline].

  4. Anas N, Namasonthi V, Ginsburg CM. Criteria for hospitalizing children who have ingested products containing hydrocarbons. JAMA. Aug 21 1981;246(8):840-3. [Medline].

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  6. Colucciello SA, Tomaszewski C. Substance abuse. In: Emergency Medicine, Concepts and Clinical Practice. 4th ed. 1998:2879-901.

  7. Dice WH, Ward G, Kelley J, Kilpatrick WR. Pulmonary toxicity following gastrointestinal ingestion of kerosene. Ann Emerg Med. Mar 1982;11(3):138-42. [Medline].

  8. Eade NR, Taussig LM, Marks MI. Hydrocarbon pneumonitis. Pediatrics. Sep 1974;54(3):351-7. [Medline].

  9. Klein BL, Simon JE. Hydrocarbon poisonings. Pediatr Clin North Am. Apr 1986;33(2):411-9. [Medline].

  10. Lee DC. Hydrocarbons. In: Emergency Medicine, Concepts and Clinical Practice. 4th ed. 1998:1362-6.

  11. Ramon MF, Ballesteros S, Martinez-Arrieta R, et al. Volatile substance and other drug abuse inhalation in Spain. J Toxicol Clin Toxicol. 2003;41(7):931-6. [Medline].

  12. Scalzo AJ. Inhalation injuries. In: Pediatric Emergency Medicine, Concepts and Clinical Practice. 2nd ed. 1997:590-3.

  13. Shis RD. Hydrocarbons. In: Goldfrank's Toxicologic Emergencies. 6th ed. 1998:1383-95.

  14. Ureta Raroque SS, Wiebe RA. Household products and environmental toxins. In: Essentials of Pediatric Intensive Care. 2nd ed. 1997:908-35.

  15. Wax PM, Beuhler MB. Hydrocarbons and volatile substances. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 6th ed. 2004:1124-9.

 
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