This document discusses kerosene oil poisoning. It notes that ingestion can cause aspiration pneumonitis and hypoxia. Symptoms include a burning sensation, nausea, vomiting, cough, dyspnea and cyanosis. Chest x-rays may show perihilar densities, basilar pneumonitis or atelectasis. Management involves oxygen supplementation, intubation if needed, and observation for respiratory symptoms over 6-8 hours. Activated charcoal and induction of vomiting are not recommended for kerosene ingestion.

1. DR. KALPANA CHETIA
ASSOC . PROF. OF MEDICINE
JMCH, JORHAT

2.  Kerosene oil is a hydrocarbon derived from petroleum
distillation.
 Other hydrocarbons which are less often involved in
poisoning cases include methane, carbon tetra
chloride , DDT , benzene , toluene etc.

3. FEATURES OF KEROSENE OIL
POISONING
 Ingestion of kerosene oil produces aspiration
pneumonitis which results in hypoxia.
 Ingestion generally produces an immediate burning
sensation in the mouth and pharynx.
 It also produces nausea and vomiting.
 In the absence of aspiration about 40- 60 ml/kg of
kerosene can be tolerated without any systemic effects.

4. FEATURES OF KEROSENE OIL
POISONING
 Aspiration of even 0.2 ml of kerosene can produce
chemical pneumonitis . This cause tachypnoea, cough,
dyspnoea , cyanosis and pulmonary edema . Fever and
leukocytosis are usual.
 CNS depression accompanying kerosene ingestion is
the result of hypoxia . It is manifested by drowsiness,
convulsions and coma .
 Rarely ingestion of kerosene produces ventricular
arrhythmias.

5. CHEST x-RAY
 It may reveal perihilar densities, basilar pneumonitis
or atelectasis or occasionally area of consolidation .
 Uncommon features include pneumatoceles ,
emphysema , pleural effusion, pneumothorax,
pneumomediastinum and pneumopericardium .
 Pneumatoceles occur at the earliest of five to six days
after ingestion and cause no impairment of respiratory
function .

6. CHEST x-RAY
 These are generally large , septate , irregular and
sometimes contain air fluid level. These resolve slowly
and may take 6-9 months for their complete
resolution.
 About 88 percent of the x-ray films that may
eventually be positive , demonstrate clinical signs of
poisoning within 2 hours after the ingestion.
 Significantly , remaining 12 percent of the patients
destined to have delayed x-ray demonstrated
abnormalities , will not develop significant respiratory
compromise or complications in most of the cases.

7. MANAGEMENTS
 Perform suctions to remove secretions from upper
airways.
 Evaluate and maintain the ventilatory status of the
patient .( measure the Spo2 and respiration rate .)
 Administer oxygen to all patients with respiratory
symptoms .
 If oxygen administration is not effective , intubate and
ventilate the patient.

8. GASTRIC DECONTAMINATION
 Avoid induction of emesis or gastric lavage .
 Activated charcoal is not indicated as it does not
adsorb kerosene oil.

9. MANAGEMENTS
 Patients who have initial symptoms of pulmonary
aspiration following ingestion need evaluation for
respiratory compromise .
 Get a chest x-ray no sooner than 2 hours post –
ingestion . If the patient is asymptomatic at that time
and the chest x-ray is normal , discharge the patient
for observation at home.

10. MENEGEMENTS
 Observe any symptomatic patient with positive chest
x-ray in the emergency department . If the patient
remains asymptomatic for 6-8 hours , discharge for
further observation at home.
 Admit all patients who have respiratory symptoms on
arrival even if the chest x-ray is normal.
 Corticosteroids and antibiotics are not useful.
 Avoid epinephrine as it may precipitate ventricular
arrhythmias.

11. PRACTICAL TIPS
 Kerosene oil is a common vehicle for other toxic
compounds. In such situation , additional toxic
features related to the added compound may occur.
 Do not induce vomiting or perform gastric lavage if the
patient has ingested pure kerosene oil.

12.  THANK YOU