A 3 years old child brought by his family with h/o ingesting unknown amount of charcoal lighter 30 minutes ago . He have vomited once , otherwise no other symptoms. On arrival to ED , his vitals within normal for his age , he was active and playful , and systemic examination is unremarkable . Your junior went to see the child and came to discuss with you his plan of management. He want to give him activated charcoal and keep him for 2 hours observation and then discharged home.
Q1. Do you agree with your junior's management plan ?
Q2 What are the expected toxicity with such ingestion ?
Lighter Kid Cont'
Thank you all for your excellent comments .Proud of you all
Key points
1.Hydrocarbon ingestion commonly cause CNS, respiratory and cardiac effects
2.Activated charcoal and any other GI decontamination is contraindicated in hydrocarbon poisoning
There are many types of hydrocarbons ,but many share the chemical pnemonitis risk.Halogonated hydrocarbon have more risk of cardiac toxicity ( check stormy night post)
This includes ventricular dysrhythmias due to myocardial sensitization to catecholamines.This can cause risk of sudden sniffing death in hydrocarbon sniffing.
Management For asymptomatic patient, they need observation for 6 hours after which they can be discharged with follow up.Early CXR for asymptomatic patient have low yield in predicting delayed pnemonitis Symtpmatic patient need admission and treatment usually supportive
References
1.National Management Guidelines of Poisoning ,3rd edition
2.https://wikem.org/wiki/Hydrocarbon_toxicity