This document summarizes the clinical presentation, signs, radiographic findings, and management of hydrocarbon poisoning from inhalation or ingestion. The initial symptoms are respiratory in nature and include choking, coughing, and vomiting. Chest X-rays typically show perihilar or lobar densities within a few hours that can persist for days. Treatment is supportive, with attention to respiratory symptoms, and antibiotics may be used if bacterial pneumonia develops. Prevention efforts include storing kerosene out of children's reach and clearly labeling containers.
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Kerosene poisoning
1. poisoning
This seminar is introduced by :
AbdulAziz Zidan
Ibraheem Atallah
Ahmed Moayad
Supervised by: Dr.Farah
2. Clinical presentation
Respiratory :
Chocking, gagging, and coughing usually begins immediately
or within 2-5 min of aspiration and persists.
Oral pain may occur in irritating hydrocarbons ingestion.
Vomiting is common and it may increase the risk of
aspiration but not necessary for it.
In most children, the initial symptoms resolve without
develpment of aspiration pneumonitis.
4. Radiographic findings
Often occur before the development of physical
findings.
They may be seen within 20 minutes or as late as
24 hour after aspiration.
CXR abnormalities typically peak between 2-4
hours after aspiration.
The resolution of radiographic changes is gradual
and lags behind clinical improvement, which
usually occurs 3-5 days after aspiration.
5. Chest X-Ray findings are hetrogenous and may include
perihilar, basal, or lobar densities.
These findings can be found in asymptomatic patients.
6. Early X-Ray within few hours
shows increased bronchovascular
markings.
After six days shows marked
consolidation.
7. Another patient presented at
the eighth day with Rt.sided
hydrorpneumothorax.
Decreased Rt.sided
hydropneumothorax with
drainage tube in situ.
9. CVS :
Cardiac arrhythmia may occur after inhalation.
Solvent hydrocarbons can sensitize the myocardium to
catecholamines.
GIT:
Ingestion of aliphatic hydrocarbons causes direct local
irritation to the pharynx, oesophagus, stomach, and small
intestine, with oedema and mucosal ulceration, and it may
be associated with nausea and haematemesis.
These effects are usually mild and rarely require treatment.
10. CNS :
HC ingestion or inhalation may have direct CNS effects as
somnolence, headache, ataxia, dizziness, blurred vision,
weakness, fatigue, lethargy, stupor, seizure, and coma.
In addition hypoxia caused by HC aspiration may cause 2ry
CNS depression including, drowsiness, tremor, or
convulsions.
Haematologic :
Leukocytosis with fever occurs early in the clinical course of
HC aspiration, unrelated to pneumonitis and may last as
long as one week.
Haemolysis, haemoglobinuria, and consumptive
coagulopathy also may occur with significant ingestion.
12. Treatment is usually supportive, with attention to
respiratory and CNS symptoms.
Observe in ER for 6-8 hours if no symptoms=Discharge
13. Do not induce vomiting.
Do not attempt gastric lavage.
If gastric lavage is to be performed, the patient should be
intubated with a cuffed ETT to protect airways.
Bronchospasm should be treated with selective beta 2
agonists.
Avoid epinephrine and isoproterenol ??
Corticosteroid should be avoided.
Antibiotics are given if bacterial pneumonia occurs.
15. Household kerosene should be kept away
from children’s reach.
The word ‘poison’ should be exhibited
prominently on the containers of kerosene.
Kerosene oil should not be stored in tumblers
or beverage bottles.