Pants on Fire

​A 37-year-old man presented to the ED with thigh pain. He said his e-cigarette battery exploded in his pants pocket after he placed his keys in the pocket. He said he took his pants off immediately and noted that the battery had melted.His initial vital signs were a temperature of 98.7°F, heart rate of 112 bpm, blood pressure of 159/95 mm Hg, and pulse oximetry of 98% on room air. He had a large area of burns of different degrees on his right thigh. Total body surface area of nine percent with first-, second-, and third-degree burns was noted.E-cigarette use, or vaping, has risen significantly in the past 10 years. The device heats up a nicotine-containing solution that is inhaled. They may also be used to deliver other drugs like marijuana. The vast majority of these devices are powered by lithium ion batteries. These batteries are more typically used because they are lightweight and store more energy than other batteries, but they are also susceptible to thermal runaway, a condition involving overheating and spontaneous explosion. Circumstances that can lead to explosions include improper storage and charging, modifications of the device, and defective or poor-quality devices.Reported e-cigarette explosion injuries include flame burns, chemical burns (alkali), blast injuries, inhalation injuries, and fractures. Patients have presented with injuries to the face (20%), hands (33%), and thigh and groin (53%).How Should These Burns be Managed?Wounds should be carefully irri...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs