eMedicine Specialties > Emergency Medicine > Toxicology

Toxicity, Hydrocarbons: Follow-up

Author: Michael D Levine, MD, Physician, Department of Medical Toxicology, Banner Good Samaritan Medical Center
Coauthor(s): Chip Gresham III, MD, Fellow, Department of Medical Toxicology, Banner Good Samaritan Medical Center, Phoenix Children's Hospital; Attending Physician, Department of Emergency Medicine, Arizona Heart Hospital
Contributor Information and Disclosures

Updated: Apr 30, 2009

Follow-up

Further Inpatient Care

  • Following a 6-hour observation period during which a patient has a normal chest radiograph and never developed any symptoms (including coughing, vomiting, respiratory difficulty) of hydrocarbon exposure, the patient can be safely discharged home with close follow-up (reevaluation in 24 h).
  • Patients who develop any symptoms of hydrocarbon exposure during the 6-hour observation should be admitted to a unit capable of continuous pulse oximetry.
  • Patients should be closely observed for any evidence of respiratory deterioration.
  • Patients with radiographic evidence of pneumonitis should receive repeat chest radiographs every 24 hours (or sooner, if clinically indicated) to ensure the pneumonitis is not progressing.

Deterrence/Prevention

  • Prevention of nonintentional poisonings includes clearly labeling containers that contain hydrocarbons.
  • Prevention of toxicities as a result of recreational drug use includes educating teens about the risks associated with such behavior.

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider hydrocarbon exposure in patients with change of mental status, in young patients with sudden cardiac arrest, and in patients presenting with weakness and profound hypokalemia consistent with RTA
  • Failure to observe patients for evidence of toxicity for a minimum of 6 hours post ingestion
  • Failure to admit patients with signs of respiratory toxicity to the hospital
  • Failure to recognize the high pulmonary toxicity of hydrocarbons and the risk of aspiration with gastric lavage
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Timothy P Barron, DO, and Jeremiah J Johnson, MD, to the development and writing of this article.



More on Toxicity, Hydrocarbons

Overview: Toxicity, Hydrocarbons
Differential Diagnoses & Workup: Toxicity, Hydrocarbons
Treatment & Medication: Toxicity, Hydrocarbons
Follow-up: Toxicity, Hydrocarbons
Multimedia: Toxicity, Hydrocarbons
References
[ CLOSE WINDOW ]

References

  1. Bronstein AC, Spyker DA, Cantilena LR Jr, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS). Clin Toxicol (Phila). Dec 2007;45(8):815-917. [Medline].

  2. Seymour FK, Henry JA. Assessment and management of acute poisoning by petroleum products. Hum Exp Toxicol. Nov 2001;20(11):551-62. [Medline].

  3. Lifshitz M, Sofer S, Gorodischer R. Hydrocarbon poisoning in children: a 5-year retrospective study. Wilderness Environ Med. 2003;14(2):78-82. [Medline].

  4. Gross P, McNerney JM, Babyak MA. Kerosene pneumonitis: an experimental study with small doses. Am Rev Respir Dis. Nov 1963;88:656-63. [Medline].

  5. Rodricks A, Satyanarayana M, D'Souza GA, Ramachandran P. Turpentine-induced chemical pneumonitis with broncho-pleural fistula. J Assoc Physicians India. Jul 2003;51:729-30. [Medline].

  6. Borne J, Riascos R, Cuellar H, Vargas D, Rojas R. Neuroimaging in drug and substance abuse part II: opioids and solvents. Top Magn Reson Imaging. Jun 2005;16(3):239-45. [Medline].

  7. Filley CM, Halliday W, Kleinschmidt-DeMasters BK. The effects of toluene on the central nervous system. J Neuropathol Exp Neurol. Jan 2004;63(1):1-12. [Medline].

  8. Garrettson LK. n-Hexane and 2-Hexanone. In: Sullivan JB, Krieger GR, eds. Clinical Environmental Health and Toxic Exposure. 2nd ed. Philadelphia, Pa: Lippincott Williams and Wilkins; 2001:1211-14; chap110.

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

  10. Palmer RB, Phillips SD. Chlorinated hydrocarbons. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders; 2007:1347-61.

  11. Algren JT, Rodgers GC Jr. Intravascular hemolysis associated with hydrocarbon poisoning. Pediatr Emerg Care. Feb 1992;8(1):34-5. [Medline].

  12. Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Heard SE. 2007 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 25th Annual Report. Clin Toxicol (Phila). Dec 2008;46(10):927-1057. [Medline]. [Full Text].

  13. Anderson CE, Loomis GA. Recognition and prevention of inhalant abuse. Am Fam Physician. Sep 1 2003;68(5):869-74. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

hydrocarbon toxicity, hydrocarbon poisoning, hydrocarbon exposure, hydrocarbon, hydrocarbon ingestion, inhaling hydrocarbons, hydrocarbon inhalation, halogenated hydrocarbons, carbon tetrachloride, trichloroethylene, tetrachloroethylene, trichloroethane, chloroform, methylene chloride, kerosene, gasoline, naphtha, wood-derived hydrocarbons, turpentine, pine oil, petroleum distillates, short-chain hydrocarbons, butane, long-chain hydrocarbons

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Michael D Levine, MD, Physician, Department of Medical Toxicology, Banner Good Samaritan Medical Center
Michael D Levine, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, American College of Medical Toxicology, American Medical Association, Emergency Medicine Residents Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Chip Gresham III, MD, Fellow, Department of Medical Toxicology, Banner Good Samaritan Medical Center, Phoenix Children's Hospital; Attending Physician, Department of Emergency Medicine, Arizona Heart Hospital
Chip Gresham III, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Medical Toxicology, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

David A Peak, MD, Assistant Residency Director of Harvard Affiliated Emergency Medicine Residency, Attending Physician, Massachusetts General Hospital; Consulting Staff, Department of Hyperbaric Medicine, Massachusetts Eye and Ear Infirmary
David A Peak, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

John T VanDeVoort, PharmD, Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals
John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists
Disclosure: Nothing to disclose.

Managing Editor

John G Benitez, MD, MPH, FACMT, FACPM, FAAEM, Associate Professor, Department of Medicine, Clinical Pharmacology Division, Vanderbilt University; Managing Director, Tennessee Poison Center
John G Benitez, MD, MPH, FACMT, FACPM, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Medical Toxicology, American College of Preventive Medicine, Society for Academic Emergency Medicine, Undersea and Hyperbaric Medical Society, and Wilderness Medical Society
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD, Assistant Professor, Department of Surgery, Section of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.