Volatile Solvents
Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T53 DESCRIPTION Inhalants include: spray-paint, glue and paint thinners that may contain hydrocarbons such as toluene and/or n-Hexane. If these are ingested, hydrocarbon poisoning with possible chemical pneumonitis must also be considered. DIAGNOSTIC CRITERIA distinctive odour, euphoria,
Description
Diagnostic criteria
General and supportive measures
Medicine treatment
Referral
ICD-10 code: T53
DESCRIPTION
Inhalants include: spray-paint, glue and paint thinners that may contain hydrocarbons such as toluene and/or n-Hexane. If these are ingested, hydrocarbon poisoning with possible chemical pneumonitis must also be considered.
DIAGNOSTIC CRITERIA
- distinctive odour,
- euphoria,
- discolouration around mouth/nose,
- headaches,
- palpitations,
- progressive CNS depression,
- dizziness,
- syncope,
- cardiac arrhythmias,
- hypokalaemia,
- mucous membrane irritation, i.e. sneezing, coughing and tearing,
- GIT complaints, i.e. nausea, vomiting and abdominal pain,
- distal renal tubular acidosis, i.e. hyperchloraemic metabolic acidosis with a normal anion gap.
- Complications include peripheral neuropathy and hepatotoxicity.
GENERAL AND SUPPORTIVE MEASURES
- Stabilise airway, breathing and circulation.
- Perform a chest X-ray if respiratory symptoms present.
- Monitor patient for respiratory symptoms: if absent after 6–8 hours, child can be discharged.
- Correct fluid and electrolyte abnormalities.
MEDICINE TREATMENT
For agitation:
- Diazepam, IV/oral, 0.1–0.2 mg/kg.
- Maximum dose: 10 mg.
For cardiac dysrhythmias, e.g. ventricular fibrillation, see: Cardiovascular System, Cardiac dysrhythmias.
REFERRAL
- Cardiac dysrhythmia.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 18: Poisoning, 18.1 Poisoning, 18.1.5 Volatile Solvents