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15 Cards in this Set

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What are the four common presentations of hydrocarbon exposure?
1 - Accidental ingestion (children)
2 - Intentional inhalation (huffing)
3 - Accidental inhalation (workplace)
4 - Suicide attempt
What are hydrocarbons?
A diverse group of organic compounds aka petroleum distillates contain hydrogen and carbon.
They can be straight chain, branched, benzene ring and/or have halogens attached.
What are the four characteristics of hydrocarbons?
-Viscosity (how easily it spreads)
-Volatility (how easily it turns into a gas)
-Surface tension (how easily it collects on a surface)
-Chemical side change (increase toxicity)
What are some common hydrocarbons?
Furniture polish
Gasoline
Butane
Toluene
Kerosene
Terpentine
Chloroform
Freon
Where do hydrocarbons cause toxicity?
Lungs
CNS
Heart
How do hydrocarbons affect the lungs?
Aspiration leads to respiratory failure through multiple mechanisms:
-causes bronchospasm and inflammation
-displaces O2 (asphyxiant)
-injures alveoli/capilleries (alveolitis, microabscesses)
-inhibit surfactant function (alveolar collapse)
How do hydrocarbons affect the CNS?
HC's diffuse through the pulmonary alveoli and are absorbed.
Acutely: rapid onset/recovery of euphoria, disinhibition, confusion, obtundation
Chronically: peripheral neuropathy, cerebellar degeneration, neuropsych disorders, encephalopathy, dementia
How do hydrocarbons affect the heart?
Thought to produce myocardial sensitization to catecholamines
This predisposes abusers to dysrhythmias and myocardial dysfunction
What other effects can hydrocarbons have?
RTA
Leukemia
Carbon monoxoide poisoning
Hepatix necrosis
Chemical burns
What is the most fatal hydrocarbon ingestion scenario?
A childhood ingestion of hydrocarbons
What is the aphorism regarding GI ingestion of hydrocarbons?
"The safest place in the body for hydrocarbons is the duodenum"
How do hydrocarbons affect the skin?
They can cause burns
How is dermal hydrocarbon exposure managed?
Remove contaminated clothing and wash skin copiously with soap and lukewarm water
How is GI hydrocarbon exposure managed?
Generally should leave it there, except if there are CHAMP additives:
Camphor - seizures
Halogenated HC - dysrhythmias/hepatotoxicity
Aromatic HC - bone marrow suppression/cancer
Metals (arsenic, murcury & lead)
Pesticides - cholinergic crises/seizures/resp depression
How should patients be observed after a hydrocarbon ingestion/inhalation?
4-6 hours of cardiorespiratory monitoring for asymptomatic patients. Admit symptomatic.
Consider repeat chest radiographs and ABG's