Accidental Kerosene Ingestion
Hydrocarbon poisoning, particularly kerosene, is a common pediatric emergency. The primary risk is aspiration pneumonitis, which can occur even with minimal ingested volumes.
1. Pathophysiology: The Danger of Aspiration
- Low Viscosity: Spreads rapidly over mucosal surfaces and into the lower respiratory tract.
- Surfactant Inactivation: Leads to alveolar collapse, ventilation-perfusion mismatch, and severe chemical pneumonitis.
- Systemic Absorption: Can cause central nervous system depression and cardiac arrhythmias.
2. Clinical Presentation & Management
| Clinical Sign | Action |
|---|---|
| Respiratory Distress | Assess SpO2, provide O2, and CXR to evaluate for pneumonitis. |
| CNS Depression | Monitor level of consciousness; protect the airway. |
3. Crucial “Do Nots.”
- DO NOT induce vomiting: This significantly increases the risk of aspiration.
- DO NOT perform routine gastric lavage: Unless a massive, life-threatening amount was ingested and the airway is secured, the risk of aspiration outweighs the benefits.
NEET PG Hint: Remember that “Aspiration is the villain” in kerosene poisoning. Even if the child is asymptomatic initially, observe them for 6–8 hours for the development of respiratory symptoms. If a CXR is performed, remember that lung changes may take several hours to appear.