L7: Hydrocarbons Flashcards
sources of hydrocarbons
mainly derived from petroleum distillation.
Forms of hydrocarbons
solvents, degreasers, fuels, lubricants.
What does toxic effect of hydrocarbons depend on?
- Volatility and viscosity of the substance
- Capability of organic solvent to dissolve the bond between cell membranes lipids leading to tissue irritation.
Volatility and viscosity of the hydrocarbons
- High viscosity + Low volatility = Low risk of systemic toxicity and aspiration.
- Low viscosity + high volatility = High risk of systemic toxicily and aspiration.
Capability of organic solvent to dissolve the bond between cell membranes lipids leading to tissue irritation.
CP of Hydrocarbons toxicity
- Local manifestations
- Systemic manifestation
Local Manifestations of Hydrocarbons toxicity
- GIT Manifestations
- Respiratory manifestation
- Dermal & Ocular manifestations
GIT manifestations of Hydrocarbons toxicity
- Abrupt nausea, vomiting, and occasionally with hemorrhagic gastroenteritis
Respiratory manifestation of Hydrocarbons toxicity
Pulmonary aspiration:
- Immediate onset of coughing or choking.
- This may progress within minutes or hours to a chemical pneumonitis characterized by respiratory distress.
- Fever develops with 2ndry bacterial infection.
Dermal and ocular manifestations of Hydrocarbons toxicity
- Skin or eye contact may cause local irritation, burns, corneal injury.
Systemic manifestations of Hydrocarbons toxicity
- CNS manifestations
- CVS manifestations
CNS manifestations of Hydrocarbons toxicity
- Often includes confusion, lethargy, and headache.
- With significant exposure: syncope, coma, and respiratory arrest may occur.
Cardiac manifestations of Hydrocarbons toxicity
Cardiac Dysrythmia
- Due to myocardial sensitization to circulating catecholamines especially with halogenated and aromatic compounds.
- Many agents also may cause hepatic and renal injury
What type of Hydrocarbons toxicity Causes Cardiac dysrythmia?
halogenated and aromatic compounds.
Investigations in cases of Hydrocarbons toxicity
- Bedside tests
- Lab tests
- Rad tests
Bedside tests for Hydrocarbons toxicity
Pulse oximetry: At time of arrival, every 2 hours until discharge.
ECG & Cardiac Mentoring: For cardiac dysrhythmias
Lab tests for Hydrocarbons toxicity
- ABG, complete blood count, urine analysis, liver and kidney
- Serial tracheal aspirates if a bacterial pneumonia is suspected.
Rad tests for Hydrocarbons toxicity
Chest x-ray:
- Positive findings in > 65% in first 6 hours after exposure.
- Abnormalities may occur as early as 30 minutes or as late as 12 hours
Aspects of treatment of Hydrocarbons toxicity
- Emergency & supporfive measures
- GIT Decontamination
- Enhanced elimination?
- Antidote
- Symptomatic treatment
Emergency and supportive treatments for Hydrocarbons toxicity
- Core of ABCDE.
- Admission to the ICU: For frequent ABG’s, chest-X ray and continuous cardio-rospiratory monitoring for patients with respiratory distress, Intubation considered if indicated.
GIT decontamination in cases of Hydrocarbons toxicity
- Emesis
- Gastric Lavage
- Activated Charcoal
Is emesis indicated in Hydrocarbons toxicity?
Contraindicated, May lead to aspiration.
Gastric lavage in Hydrocarbons toxicity
- May be indicated in case of large ingestions
- Or hydrocarbon mixed with toxic additives as Leaded gasoline & Halogenated hydrocarbons (Endotracheal intubation is done in advance).
Activated Charcoal in Hydrocarbons toxicity
- does not bind to hydrocarbons
- may trigger aspiration.
antidote in cases of Hydrocarbons toxicity
No role for antidotes in hydrocarbon toxicity except:
- In mixed toxicities with organophosphate pesticides.
- In cases ingested leaded gasoline in significant amount.
Enhanced Elimination in cases of Hydrocarbons toxicity
No role in hydrocarbon toxicity.
Symptomatic treatment in cases of Hydrocarbons toxicity
