May 2021: The Asphyxiants that Cause Pulmonary Toxicity

​The American Association of Poison Control Centers reported more than 37,000 exposures to gas, fumes, and vapors in 2019, and those were the most common exposures in pediatric deaths. Toxicity from gas, fume, and vapor exposures can be categorized by their mechanism: simple asphyxiants, pulmonary irritants, and systemic asphyxiants.Simple AsphyxiationSimple asphyxiants work by displacing oxygen from ambient air. Patients may be exposed to these chemicals by huffing. A 2010 survey reported that more than two million adolescents in the United States ages 12-17 reported using inhalants at least once, including noble gases (helium), nitrogen gas (nitrous oxide), and aliphatic hydrocarbons (methane, ethane, propane). Gas is inhaled by discharging nitrous gas cartridges, often called whippets, into an object like a balloon or directly into the mouth. Credit: evemilla/iStockphoto.comSimple Asphyxiant SymptomsSymptoms are consistent with hypoxia and include tachypnea, lethargy, nausea and vomiting, seizures, and death. Patients who have been huffing may present with burns on the oral mucosa. This patient presented after huffing with swollen lips, bullae on the lateral margin of the mouth, and midline burns. (Courtesy Brandie LaSala, MD; Pediatr Dermatol. 2013;30[4]:e57; https://bit.ly/3ujAWqm.)Treatment for Simple AsphyxiantsTreatment is the immediate removal from the exposure and supplemental oxygen. Assisting with respirations may be needed until a pati...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs