Hydrocarbon Flashcards
What is the 3rd leading cause of poisoning deaths in children under 5 years old in the US?
Hydrocarbon aspiration and smoke inhalation
Highest morbidity and mortality in children under 5 years old.
What are the most commonly ingested materials leading to hydrocarbon toxicity?
- Household cleaning products
- Solvents
- Fuels
What is the most common and serious complication of hydrocarbon ingestion?
Pneumonitis
What are some other organs that can be affected by hydrocarbon toxicity?
- CNS abnormalities
- GI irritation
- Cardiomyopathy
- Renal toxicity
What lung pathologies are associated with fatal cases of hydrocarbon aspiration?
- Necrosis of bronchial, bronchiolar, and alveolar tissue
- Atelectasis
- Interstitial inflammation
- Hemorrhagic pulmonary edema
- Vascular thromboses
- Necrotizing bronchopneumonia
- Hyaline membrane formation
What factors increase the likelihood of aspiration of hydrocarbons?
- Low surface tension
- Low viscosity
- High volatility
What clinical findings may occur after hydrocarbon aspiration?
- Cough
- Hemoptysis
- Pulmonary edema
- Respiratory failure
When do radiographic signs of chemical pneumonitis typically develop after hydrocarbon ingestion?
Within 2 hours (88%) and within 6–12 hours (98%)
What blood gas finding is commonly associated with hydrocarbon aspiration?
Hypoxemia without hypercapnia
What is the general management approach for hydrocarbon ingestion?
Generally supportive
What should be avoided in the management of hydrocarbon ingestion to prevent aspiration?
Emetics or gastric lavage
What role do corticosteroids play in the management of hydrocarbon aspiration?
No role for steroids
What is a key prevention strategy for accidental hydrocarbon ingestion?
Education about storage and labeling
What factors influence the prognosis of hydrocarbon aspiration?
- Type of substance aspirated
- Volume of substance
- pH of substance
What is the predominant cause of death among fire victims related to smoke inhalation?
Carbon monoxide poisoning
What are some chemical factors that contribute to smoke inhalation injury?
- Oxides of sulfur and nitrogen
- Acetaldehydes
- Hydrocyanic acid
- Carbon monoxide (CO)
What are the initial pathologic changes in smoke inhalation?
Tracheobronchitis
What symptoms may indicate carbon monoxide poisoning?
- Headache
- Diminished visual acuity
- Irritability
- Nausea
What is a sensitive indicator of cyanide poisoning?
Plasma lactate concentration > 10 mM
What is a common clinical finding in smoke inhalation cases?
Facial burns or singed nasal hairs
What is a critical step in managing smoke inhalation injury?
Administration of high concentrations of humidified oxygen (100%)
What is the effect of carbon monoxide on hemoglobin?
Forms carboxyhemoglobin (COHb), impairing tissue oxygenation
What are the potential long-term effects of smoke inhalation on children?
- Obstructive lung disease
- Reduced lung function
What should be assessed during direct laryngoscopy in smoke inhalation cases?
Evidence of severe obstruction
