Petroleum Distillate Poisoning

Toxicity may occur from inhalation of the vapor or as a result of pulmonary aspiration of the liquid during or after ingestion

Acute manifestations of aspiration pneumonitis

• Vomiting

• Coughing

• Bronchopneumonia

With some hydrocarbons (eg, phenol, carbon tetrachloride), severe systemic poisoning can occur after oral ingestion

Systemic intoxication can also occur by inhalation of volatile hydrocarbons

Vertigo, muscular incoordination, irregular pulse, myoclonus, and seizures occur with serious poisoning and may be due to hypoxemia or the systemic effects of the agents

Chlorinated and fluorinated hydrocarbons (eg, trichloroethylene, freons) and many other hydrocarbons can cause ventricular arrhythmias because of increased sensitivity of the myocardium to the effects of endogenous catecholamines

Coughing or choking immediately after ingestion suggests pulmonary aspiration

Chest film findings may be delayed for several hours

Chronic toluene abuse associated with renal tubular acidosis, hypokalemia

Move the patient to fresh air

Administration of activated charcoal (60–100 g mixed in aqueous slurry orally or via gastric tube) may be helpful if the preparation contains toxic solutes (eg, an insecticide) or is an aromatic or halogenated product

Observe the victim for 6–8 h for signs of aspiration pneumonitis

Corticosteroids are not recommended

If fever occurs, give a specific antibiotic only after identification of the bacterial pathogens

Because of the risk of arrhythmias, use bronchodilators with caution in patients with chlorinated or fluorinated solvent intoxication

If tachyarrhythmias occur, use esmolol 25–100 mcg/kg/min intravenously