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Petroleum Distillates Poisoning

Poisoning by Fuels and Cleaners Petroleum Spirits Naphtha


Presentation

  • Christmas Decorations: Solid wax candles are considered non-poisonous; neither coloring nor scent is present in an amount large enough to be significant. However, if large amounts are swallowed, diarrhea may develop.[illinoispoisoncenter.org]
  • Note:clinical presentation is better predictor of clinical course than the chest X-ray • other- increased transaminases 18. TREATMENT • HOME TREATMENT • TREATMENT IN HOSPITAL 19.[slideshare.net]
  • Activated charcoal, combined with a cathartic, is also indicated in most poisonings presenting within 60 minutes of ingestion.[aafp.org]
  • Clinical presentation included epigastric pain, abdominal swelling, bloody diarrhoea, hepatomegaly, splenomegaly, and ascites .[flipper.diff.org]
  • Additionally, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome.[medicinesinpregnancy.org]
Cough
  • Anything beyond an initial cough requires hospital assessment. All patients who are clinical well at 6 hours are medically fit for discharge. This requires normal vital signs including saturations, no cough, wheeze or dyspnoea.[lifeinthefastlane.com]
  • Sometimes when a hydrocarbon is aspirated, the coughing does not begin until much later. It is possible for symptoms to be delayed for 6-24 hours.[chop.edu]
  • Signs and symptoms Acute exposure * If liquid is swallowed: - coughing and choking almost immediately, - vomiting, - sore throat and a burning feeling in the mouth.[helid.digicollection.org]
  • Sharper definition of, and closer adherence to, criteria for complications including a history of the presence of cough or gagging at the time of ingestion, and the routine use of serial x-ray. 3.[pediatrics.aappublications.org]
  • Respiratory symptoms -Early tachypnoea ,rales hemoptysis ,gagging choking ,transient cyanosis,pumonary edema,continued non productive cough -late pnemonia( chemical and bacterial) 13.[slideshare.net]
Rales
  • Respiratory symptoms -Early tachypnoea ,rales hemoptysis ,gagging choking ,transient cyanosis,pumonary edema,continued non productive cough -late pnemonia( chemical and bacterial) 13.[slideshare.net]
  • Atropine IV (preferably or IM) Adults, children 12 years, 2.0 to 4.0 mg every 15 minutes until secretions controlled; children Furosemide (Lasix), 40 to 160 mg, if basilar rales persist after atropinization Pralidoxime not indicated in pure carbamate[aafp.org]
Dyspnea
  • […] lye) or strong acids (vomiting may cause additional injury to the esophagus {02} {04} {22} ) Risk-benefit should be considered when the following medical problems exist Heart disease (increased risk of tachycardia, hypotension, precordial chest pain, dyspnea[drugs.com]
Gastric Lavage
  • Gastric lavage was not harmful to the patients, but there was no conclusive evidence that it was beneficial.[pediatrics.aappublications.org]
  • Trained personnel may use gastric lavage by itself or after two doses of Ipecac syrup has failed to induce vomiting. After passing a large—caliber nasogastric tube, aspirate the stomach contents.[medical.tpub.com]
  • lavage Gastric lavage may instead increase the severity of poisoning by dissolving the substance and enhancing its absorption.[icmteaching.com]
  • Poisoning victim Prevent further absorption by administering activated charcoal, including emesis, or by administering gastric lavage and cathartics for specific treatment, contact the poison center.[slideshare.net]
  • lavage) Most symptoms are seen in people who are allergic to pyrethrins.[medlineplus.gov]
Impaired Balance
  • Tests on patients after chronic exposure to petroleum distillates have been shown to result in reduced blood flow to the brain, vestibular disturbance which can impair balance and coordination, abnormal electro cardiograph (ECG), impaired neurocognitive[ispub.com]
Vomiting
  • Approximately 95% of patients vomit within 15 to 30 minutes of administration of a therapeutic dose and vomiting usually persists for 30 minutes to 2 hours.[rxmed.com]
  • If spontaneous vomiting occurs, administer an antiemetic.[medical.tpub.com]
  • If vomiting has not occurred within 20 minutes, the dose of Ipecac Syrup can be repeated with more fluids. Only repeat dosage once. If vomiting does not occur, call your physician or the poison control center.[ipl.org]
  • They act locally by irritating the gastric mucosa and centrally by stimulating the medullary chemoreceptor trigger zone to induce vomiting. {04} {20} {21} Onset of action: 20 to 30 minutes. {02} {08} Duration of action: 20 to 25 minutes.[drugs.com]
  • Do not make the patient vomit, because liquid might get into the lungs as the patient vomits. Do not give activated charcoal, because it does not bind petroleum distillates. For lung oedema, treat as recommended in chapter five.[helid.digicollection.org]
Nausea
  • Nausea, vomiting, chest pain, dizziness, and severe depression of the central nervous system characterize the condition. Severe or fatal pneumonitis may occur if the substance is aspirated. Therefore induced emesis is contraindicated.[medical-dictionary.thefreedictionary.com]
  • The symptoms may include deep breathing, nausea, vomiting, and potentially liver damage or death. An overdose of vitamins, especially iron pills, can be quite dangerous for children.[maripoisoncenter.com]
  • Phase 1: 30 minutes - 2 hours - mild acidosis, CNS depression, corrosive effect on GI tract (nausea/vomiting). Phase 2: May see a period of apparent recovery; often not when large overdose taken.[casemed.case.edu]
  • Antiemetic suppository for nausea Administered by nasogastric tube if unable to tolerate or unable to swallow Protect airway if hydrocarbon-containing pesticide or unknown pesticide contents.[aafp.org]
  • The symptoms of an alcohol overdose may be mild, such as dizziness and nausea, or they may progress to more serious complications, such as vomiting, drowsiness, difficulty breathing, coma and death.[illinoispoisoncenter.org]
Diarrhea
  • However, if large amounts are swallowed, diarrhea may develop. Liquid fuels in glass candle lamps can be very dangerous and should be kept well out of children’s reach. Ornaments and other decorations can be a choking hazard.[illinoispoisoncenter.org]
  • Protracted or prolonged vomiting, diarrhea and lethargy may occasionally occur. Toxicity may occur in patients with eating disorders who chronically consume large amounts of ipecac syrup.[rxmed.com]
  • Cathartics Used only in combination with activated charcoal Sorbitol (1 to 2 mL/kg or 70 percent solution in adults, 1.5 to 2.5 mL/kg of 35 percent solution in children) Single dose only Not recommended in poisonings that produce diarrhea (organophosphates[aafp.org]
  • […] amphetamines, atropine, barbiturates, neostigmine(Prostigmin),scopolamine ( Scopace)Coma - Atropine, barbiturates, bromide, carbon monoxide, chloral hydrate, ethanol, paraldehyde, salicylates,scopolamine Diaphoresis – Alcohol, fluoride, insulin, physostigmine Diarrhea[slideshare.net]
  • […] overdose The following effects have been selected on the basis of their potential clinical significance (possible signs and symptoms in parentheses where appropriate)—not necessarily inclusive (may also be symptoms of chronic abuse {02} {04} {19} ): Diarrhea[drugs.com]
Abdominal Pain
  • GIT FEATURES • Irritation is common • spontaneous vomiting • nausea, diarrhoea and abdominal pain 15.[slideshare.net]
  • Ingestion symptoms are similar, but more severe; in addition to the absorption and inhalation symptoms, there may be abdominal pain, an internal burning sensation, nausea, vomiting, organ damage, and even death.[maripoisoncenter.com]
Muscle Weakness
  • Myopathy, with manifestations of muscle weakness and pain, hyporeflexia, tenderness and stiffness, has been the major presenting adverse effect.[rxmed.com]
  • Symptoms Symptoms of poisoning from these products include: Chest pain Coma Convulsions , tremors Difficulty breathing , shortness of breath, wheezing Eye irritation if it touches the eyes Muscle weakness Nausea and vomiting Rash ( allergic reaction )[m.ufhealth.org]
  • Symptoms Symptoms of poisoning from these products include: Chest pain Coma Convulsions Difficulty breathing Eye irritation if it touches the eyes Muscle weakness Nausea and vomiting Rash ( allergic reaction ) Salivating more than ususal Shortness of[stlukes-stl.com]
  • Chronic exposure Repeated abuse may result in: - loss of appetite, - loss of weight, - muscle weakness, - mental changes, - sleeplessness, irritability, restlessness, - fits. What to do Give first aid.[helid.digicollection.org]
  • weakness (nicotinic effects); peripheral cholinergic neuroeffector unctions— “all faucets on”— sweating, salivation, diarrhea, tearing (muscarinic effects); miosis (pinpoint pupils) most commonly, but 15 percent have mydriasis secondary to epinephrine[aafp.org]
Headache
  • From large amounts there may also be: - weakness, dizziness and headache, - drowsiness, - unconsciousness, - slow shallow breathing, - fits. After 6-24 hours: - wheezing and fast breathing, - lung oedema.[helid.digicollection.org]
  • […] stomach may be burnt) Severe gastrointestinal tract burns may result in perforation of the GI tract Speaking and swallowing difficulties due to swelling of tongue and throat Severe skin irritation and burns (perforations on the skin may be observed) Headaches[dovemed.com]
  • Petroleum ether is metabolized by the liver with a biological half-life of 46–48 h. [3] Inhalation overexposure causes primarily central nervous system (CNS) effects (headaches, dizzines, nausea, fatigue, and incoordination).[en.wikipedia.org]
  • Dienochlor (Pentac) Endosulfan Lindane (Kwell) Induction of hyperexcitable state in central and peripheral nervous system by disruption of normal flow of sodium and potassium across the axon membrane; may antagonize GABA-mediated inhibition in CNS Seizures, headache[aafp.org]
  • Fragrances added to many cleaners, most notably laundry detergents and fabric softeners, may cause acute effects such as respiratory irritation, headache, sneezing, and watery eyes in sensitive individuals or allergy and asthma sufferers.[organicconsumers.org]
Dizziness
  • Nausea, vomiting, chest pain, dizziness, and severe depression of the central nervous system characterize the condition. Severe or fatal pneumonitis may occur if the substance is aspirated. Therefore induced emesis is contraindicated.[medical-dictionary.thefreedictionary.com]
  • From large amounts there may also be: - weakness, dizziness and headache, - drowsiness, - unconsciousness, - slow shallow breathing, - fits. After 6-24 hours: - wheezing and fast breathing, - lung oedema.[helid.digicollection.org]
  • The symptoms of an alcohol overdose may be mild, such as dizziness and nausea, or they may progress to more serious complications, such as vomiting, drowsiness, difficulty breathing, coma and death.[illinoispoisoncenter.org]
  • […] perforations on the skin may be observed) Headaches and weaknesses If metal polish gets in the eye, then eye irritation and pain Loss of vision Severe stomach pain Blood in stool and vomit Sudden decrease in blood pressure (hypotension) Feeling nervous, dizzy[dovemed.com]
  • Symptoms of poison inhalation can include breathing problems, coughing, sore or dry throat, dizziness or burning or pain in the chest. These effects may not be immediate.[maripoisoncenter.com]
Confusion
  • It is not to be confused with Benzene .[en.wikipedia.org]
  • Advanced symptoms of alcohol poisoning include mental confusion, stupor, vomiting, seizures, low blood sugar, irregular breathing and unconsciousness. Be smart about alcohol in your house: store it out of the reach of children.[maripoisoncenter.com]
  • Hyperventilation, non-cardiogenic pulmonary oedema, respiratory arrest and aspiration pneumonitis can occur Tinnitus, deafness Tachycardia, hypotension, arrythmias Confusion, seizures, coma Severe acidosis GI bleeding, N&V Levels 50-100 moderate 100 severe[icmteaching.com]
Agitation
  • Agitation, delirium - Alcohol, amphetamines, atropine, barbiturates, neostigmine(Prostigmin),scopolamine ( Scopace)Coma - Atropine, barbiturates, bromide, carbon monoxide, chloral hydrate, ethanol, paraldehyde, salicylates,scopolamineConstricted pupils[slideshare.net]
  • Use benzodiazepine if seizures, hypertension or agitation. Can use haloperidol if inadequate response to benzo. Cocaine may cause hypertensive emergency through CNS stimulation and its peripheral α-agonist effects.[icmteaching.com]
Excitement
  • DDT general factsheet. 1999 CLINICAL ACUTE POISONING Acute effects likely in humans due to low to moderate exposure may include nausea, diarrhea, increased liver enzyme activity , irritation (of the eyes, nose or throat), disturbed gait, malaise and excitability[flipper.diff.org]

Workup

Hepatic Necrosis
  • Phase 4: 2-4 days - end organ failure, ARDS, hepatic necrosis Phase 5: 2-4 weeks - gastric scarring and stricture formation Treatment: GI decontamination is critical, activated charcoal does not bind Iron.[casemed.case.edu]

Treatment

  • TREATMENT 36. Initial treatment Emergency resuscitation Support of the patient’s ABCs and prevention further poison absorption 37.[slideshare.net]
  • TREATMENT • HOME TREATMENTTREATMENT IN HOSPITAL 19.[slideshare.net]
  • Treatment consists of chelation therapy. Most protocols don't recommend treatment for levels less than 45mcg/dl. For more specific information see The Harriet Lane Handbook, available through MDConsult (search for lead chelation).[casemed.case.edu]
  • Treatments reported other than gastric lavage were oxygen, oxygen under pressure, penicillin and other antibiotics, and corticosteroids.[pediatrics.aappublications.org]
  • The person may receive: Cleaning of exposed skin Washing and examination of eyes as needed Treatment of allergic reactions as needed If the poison was swallowed, treatment may include: Activated charcoal Blood and urine tests Breathing support, including[stlukes-stl.com]

Prognosis

  • The prognosis of Metal Polish Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient If the individual can recover from the symptoms[dovemed.com]
  • . • CLINICAL FEATURES • COMPLICATION • INVESTIGATION • TREATMENT • PROGNOSIS • CONCLUSION • REVIEW QUESTION 4.[slideshare.net]
  • Chest x-ray CT scan (advanced imaging) of the brain ECG (electrocardiogram, or heart tracing) Intravenous fluids (through a vein) Laxative Medicines to treat symptoms Tube through the mouth into the stomach to empty the stomach (gastric lavage) Outlook (Prognosis[m.ufhealth.org]
  • Chest x-ray CT scan (advanced imaging) of the brain EKG (electrocardiogram, or heart tracing) Intravenous fluids (through a vein) Laxative Medicines to treat symptoms Tube through the mouth into the stomach to empty the stomach (gastric lavage) Outlook (Prognosis[stlukes-stl.com]
  • Prognosis depends on the amount of poison absorbed, its toxicity, and the time interval between poisoning and treatment. 4. causes 5. Children accident poisoning cleaning agents insecticides paints cosmetics plants 6.[slideshare.net]

Etiology

  • ETIOLOGICAL FACTORS • Inappropriate storage • attractive colour • pleasant odour • low socioeconomic status • inquisitive nature • lack of parental awareness • hot seasons 8.[slideshare.net]

Epidemiology

  • The other cases were used to examine various epidemiologic characteristics of the problem. Gastric lavage was not harmful to the patients, but there was no conclusive evidence that it was beneficial.[pediatrics.aappublications.org]
  • The epidemiology and clinical features of paraffin (kerosene) poisoning in rural African children. Ann Trop. Pediatric 17:49–55. r-18. Risser, A. L., and Mazur, L. J. (1995). Use of folk remedies in a Hispanic population.[ispub.com]
  • Limited epidemiological studies suggest that occupational pesticide exposures are associated with AD. serum levels of dichlorodiphenyldichloroethylene (DDE), the metabolite of the pesticide dichlorodiphenyltrichloroethane (DDT), were found to be elevated[flipper.diff.org]
Sex distribution
Age distribution

Pathophysiology

  • PATHOPHYSIOLOGY Aspiration of hydrocaron inhibit surfactant alveolar instability, early distal air way closure ventilation perfusion mismatch hypoxia 10.[slideshare.net]
  • The pathophysiology of poison depends on the substance that’s inhaled or ingested. The extent of damage depends on the pH of the substance, the amount ingested, its form ( solid or liquid), and the length of exposure to it.[slideshare.net]

Prevention

  • Prevent further absorption from skin contamination, remove the clothing covering the contaminated skin and immediately flush the area with large amounts of water. 45.[slideshare.net]
  • This is why activated charcoal helps to prevent the poison from being absorbed into the body.[rebuildingcivilization.com]
  • Special care needs to be taken with all of these products to best prevent poisonings. Always store poisonous products out of the reach of children.[maripoisoncenter.com]
  • NIOSH Pocket Guide to Chemical Hazards, “VM&P Naphtha,” Centers for Disease Control and Prevention, www.cdc.gov/NIOSH/npg/npgd0664.html .[atlenv.com]

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