Ronald Chrisbianto Gani

405090223
Faculty of Medicine
Tarumanagara University
EMERGENCY MEDICINE BLOCK
HYDROCARBON
POISONING
HYDROCARBON POISONING
Rosens Emergency Medicine 7th Ed
PATHOPHYSIOLOGY
Three main target organs
Lungs, CNS, Heart
Cause most damage via lungs
Charactristics
Lower the viscocity, higher the toxicity
High volatility, enable to displace alveolar oxygen
Low surface tension, susbtance disperse easily
Chemical side chains often increase toxicity
Rosens Emergency Medicine 7th Ed
PATHOPHYSIOLOGY
Lung
Bronchospasm and inflammation
Displace oxygen in alveolar hypoxia
Direct injury to pulmonary alveoli and cappilaries
distict uniform lesion
Inhibit surfactant function alveolar collapse
CNS
Depression
Respiratory pulmonary alveoli blood and tissue
euporia, disinhibiton, confusion, obtudantion
Rosens Emergency Medicine 7th Ed
PATHOPHYSIOLOGY
Chronic use peripheral neuropathy, cerebelar
degeneration, neuropsychiatric disorders, chronic
encephalopathy, dementia
Cardiac
Sudden death
Myocardial sensitization ventricular dysrhytmia
and myocardial dysfunction
Rosens Emergency Medicine 7th Ed
CLINICAL FEATURES
Child ingest unknown amount of HC
Cyanosis, coughing, grunting, noisy respirations,
repeated bouts of vomit
Tachypnea, dyspnea, bronchospasm, wheezing,
rales, fever
Change in mental status
Extreme : respiratory failure


Rosens Emergency Medicine 7th Ed
CLINICAL FEATURES
Solvent-abuse adolescent or adult
Cardiac arrest
CNS intoxication (euphoria, agitation,
hallucinations, confusion, bizzare behavior)
CNS depression and seizure
Long term : peripheral neuropathy, cerebelar
degeneratio, encephalopathy
Rosens Emergency Medicine 7th Ed
CLINICAL FEATURES
Accidental dermal or inhaled respiratory
exposure
Not life-threathening
Asymptomatic or transient symptoms (headache,
dizziness, nausea)
Skin : erythema, swelling, blistering, dermal
destruction


Rosens Emergency Medicine 7th Ed
DIAGNOSIS
History and PE for aspiration
Significant HC exposure (tachypnea,
tachycardia, wheezing, hypoxemia) chest
radiograph
Continuous pulse oxymetri and ABG
Chronic users behavioral problems
exclude underlying disease
Rosens Emergency Medicine 7th Ed
CXR
Rosens Emergency Medicine 7th Ed
MANAGEMENT
All patients must be monitored by cardiac
monitors and pulse oxymetri
Intubation needed in severe cases
High frequency jet ventilation and exreacorporeal
membrane oygenation children with
respiratory failure secondary to aspiration
Surfactant therapy
Supportive care and close observation, no
specific antidotes
Rosens Emergency Medicine 7th Ed