Hydrocarbons and volatile substances

1. Hydrocarbons and volatile substances

2. epidemiology • most commonly occur as ingestions or inhalations • "huffing" - the individual soaks a rag with the inhalant and then places it over the mouth and nose • "bagging" - the individual puts the hydrocarbon in a bag (usually a plastic bag) and repeatedly inhales deeply from the bag • "sniffing" - the hydrocarbon is directly inhaled via the nostrils.

6. pathophys • aspiration risk increases as the viscosity decreases • direct toxic injury to the pulmonary parenchyma and altered surfactant function • coughing, choking, gasping, dyspnea, and burning of the mouth • Initial cxr may be normal but most commonly develops into bilateral infiltrates

7. toxicity • most worrisome acute complication found in solvent abusers is "sudden sniffing death syndrome” – ventricular dysrythmias • Though hydrocarbons are cns depressents, initial excitatory effects manifested as hallucinations, tremor, agitation, and convulsions occur • Paresthesias • vomiting

8. diagnosis • composite picture incorporating the findings of the history, physical examination, bedside cardiac and pulmonary monitoring, laboratory tests, and chest radiography

9. treatment

10. treatment

11. references • Tintinalli, Ch. 193