Gasoline poisoning results from the excessive ingestion of gasoline and can be acute or chronic. The most common symptoms are headache, dizziness, and intoxication. Treatment depends on the severity of symptoms and includes options of increased fluid intake and gastric lavage.
What is gasoline poisoning?
Gasoline poisoning occurs when the body ingests too much motor gasoline. It primarily affects the skin, digestive tract and respiratory system. An excess amount of gasoline can be ingested orally or inhaled. If ingested orally, the body responds with the self-protective action of vomiting, but the vomit can enter the trachea and cause asphyxiation. Depending on how long the patient is exposed to gasoline, the poisoning may be acute or chronic. The effects of gasoline poisoning vary in severity depending on how long the individual was exposed to gasoline. In addition to vomiting and nausea, there may be dizziness, intoxication with euphoria and drunkenness, headache, severe nervousness or agitation, convulsions, unconsciousness, suspension of physical reflexes, circulatory failure, and respiratory paralysis. Epileptic seizures and cyanosis have also been reported. Cyanosis is the bluish-purple discoloration of the skin and usually indicates severe internal damage.
Causes
The causes of gasoline poisoning are excessive inhalation or oral intake of gasoline. During normal exposure to the substance, such as during vehicle refueling, gasoline poisoning occurs only in exceptional cases. Those at risk are service station employees and tank cleaners if they do not comply with safety regulations, and drivers of inadequately secured gasoline transport vehicles, as well as workers and mechanics who come into contact with gasoline. Young children whose parents store gasoline in their private garage and inadequately secure it are also at particular risk. These causes usually lead to acute gasoline poisoning. The cause of chronic gasoline poisoning is usually multiple inhalation, or sniffing, of gasoline. This is said to induce a state of intoxication and often makes the affected person addicted. In addition to the symptoms of acute gasoline poisoning, anemia and neurological as well as psychological symptoms, for example, memory and concentration disorders and changes in character, may then occur.
Symptoms, complaints and signs
The acute and chronic forms of gasoline poisoning differ both in their course and in the symptoms that occur. In acute gasoline poisoning, the first symptoms are irritation of the stomach, intestines, and mouth. Furthermore, severe breathing difficulties and convulsions occur, sometimes leading to unconsciousness. If the gasoline is ingested by mouth, vomiting may occur spontaneously, and the vomit may even enter the trachea. This makes fatal choking attacks possible. Infants die if they swallow at least ten milliliters of gasoline. In adults, the lowest lethal dose is seven to eight milliliters per kilogram of body weight. Chronic gasoline poisoning is characterized by such symptoms as anemia, mucosal hemorrhage, depression, tremor, polyneuritis, and renal failure. Anemia is aplastic anemia with decrease in the number of all blood cells. Common symptoms of aplastic anemia include fatigue, headache, poor performance, nausea, pale skin, and tendency to collapse. Furthermore, constant tissue hemorrhage occurs due to the decreased number of platelets. Due to the smaller number of white blood cells, there is an increased tendency to infections. In the long term, headaches, fatigue, excitability and tremor may persist. Furthermore, there is a risk of chronic liver, kidney or pancreas damage with the subsequent symptoms. Thus, chronic digestive problems, jaundice, abdominal dropsy, and severe neurological symptoms, including dementia, may develop.
Diagnosis and course
The diagnosis of gasoline poisoning consists first of a detailed history. This is followed by a thorough physical examination, toxicologic diagnosis, and blood analysis. If necessary, a radiographic examination of the chest may be performed.In the general anamnesis, the physician must ask about previous illnesses, the ingested gasoline dose, occupational and family risks, and relevant medication intake. In this way, other diseases are ruled out and initial indications of the severity of the intoxication are found. During the general physical examination, blood pressure and pulse must be measured, pupillary reaction and reflex function checked, and body temperature measured. Further, a cardiological examination, examination of the oral pharynx and a skin analysis are part of the examination procedure. The toxicological examination, the goal of which is to detect the gasoline and the amount of gasoline, is ideally performed in vomit or urine, as both provide the most rapid results. Gastroscopy or plasma analysis may need to be initiated. The prognosis depends on the severity of the poisoning and the patient’s previous general condition, but is usually good. Only rarely are kidneys, lungs and other organs affected. Then complications such as pneumothorax, hemoptysis, or fibrosis occur.
Complications
Gasoline poisoning is a serious intervention in the body and should be treated immediately by a doctor. If not treated properly and in a timely manner, this poisoning can also lead to death in the worst case scenario. In the case of gasoline poisoning, the consequences vary greatly and depend on the amount of gasoline ingested. As a rule, the symptoms are irritation of the mouth, intestines and stomach. This is followed by shortness of breath, unconsciousness and spasms in the muscles. If the gasoline was ingested orally, vomiting often follows. In low-level gasoline poisoning, headache and drunkenness occur as a result of ingestion. These symptoms increase with the amount ingested, leading to euphoria, convulsions, and in high amounts, deep narcosis or even fatal paralysis. Therapy for gasoline poisoning takes place with kerosene oil. If larger quantities were ingested, gastric lavage takes place. Since the gasoline strongly irritates the customer, antibiotics are often prescribed here to avoid pneumonia. Gasoline poisoning must necessarily be treated by a doctor or by a hospital, because it can have dire consequences if treated incorrectly or inadequately.
When should you go to the doctor?
As a rule, in the event of gasoline poisoning, a doctor must be consulted immediately. It is also recommended to call the emergency doctor directly in case of acute poisoning to avoid complications and possibly death of the affected person. If treatment is not received, the individual may also die from gasoline poisoning. A doctor should also be consulted for gasoline poisoning if the affected person loses consciousness or suffers from dizziness and nausea. Similarly, changes in personality or general confusion may indicate gasoline poisoning, so these symptoms should be investigated. In the case of chronic gasoline poisoning, drowsiness and shortness of breath also occur. In acute emergencies, go to the hospital or call an ambulance immediately. This is especially true if the affected person can no longer move or has already lost consciousness. However, a doctor should be consulted even for small amounts of gasoline to avoid possible complications.
Treatment and therapy
Immediate measures to treat those affected by gasoline poisoning include, to the extent possible, extrication from the reach of the poisonous substance and provision of oxygen. First responders should refrain from ventilatory attempts for self-protection. If gasoline poisoning was induced orally, the victim must drink as much as possible. Forcible vomiting of the stomach contents is not advisable, as there is a risk of the vomit entering the trachea. For this purpose, there are special medications that the hospital has in stock, but if necessary, gastric lavage can be performed to remove the gasoline from the digestive tract. Other symptoms are treated with appropriate medications.
Outlook and prognosis
Mild to moderate gasoline poisoning has a good chance of complete recovery. Relief of the first symptoms already occurs as soon as pure oxygen is inhaled instead of gasoline.If countermeasures are initiated in good time and medical care is provided, the patient is usually free of symptoms within a few days or weeks. The respiratory tract heals with good treatment. The intake of sufficient fluids and the avoidance of further irritants in food intake additionally help in the healing process. Harmful substances, such as the consumption of nicotine or alcohol should be avoided to speed up the regeneration of the mucous membranes in the throat and pharynx. The prognosis for acute gasoline poisoning is less optimistic. Many patients suffer damage to the vessels, respiratory tract, or spinal cord that can no longer be successfully treated. In addition, the risk of lifelong impairment of brain activity and the nervous system increases. Damage to the cerebral cortex can result in severe sequelae. They include neuritis ischiadica or traumatic epilepsy. In addition, a defect of the lungs may occur. In severe cases, pulmonary hemorrhage sets in and organ failure occurs. Artificial respiration is necessary and essential for survival. Without transplantation of a donor lung, a life-threatening condition persists.
Prevention
Important to preventing gasoline poisoning is self-protection. This is done primarily by following standard safety rules for working with toxins. Children are best protected by secure storage of gasoline.
Aftercare
Acute or chronic gasoline poisoning requires follow-up care in all cases. There is a possibility of secondary damage to the detoxification organs, as well as the skin or other organs, in acute gasoline poisoning. The risk of cancer is increased. In the chronic form of gasoline poisoning, the poisoning has occurred insidiously over a long period of time. Here, there is a risk of a multisystem disease such as MCS. Even if mild to moderate gasoline poisoning can be treated well, the risk of late effects remains. These can occur years or decades later. Without regular follow-up, any late effects can no longer be causally linked to the poisoning. Follow-up care is also necessary because chronic gasoline poisoning is rarely recognized and treated immediately. In acute gasoline poisoning, it depends on the severity of intoxication how quickly treatment is undertaken. In this case, late damage is even more likely than in gradual and chronic gasoline poisoning. In severe poisoning, irreversible damage occurs to the respiratory tract, blood vessels, brain or nervous system. Permanent sequelae such as poisoning-related epilepsy or a lung defect require lifelong follow-up care. Transplantation or surgery may become necessary. Even such interventions do not proceed without lifelong aftercare. Drug therapy for such sequelae requires monitoring.
What you can do yourself
If gasoline poisoning is suspected, an emergency physician must be consulted. The ambulance service must be provided with all important information about the circumstances, time of poisoning and the age and state of health of the person concerned on the basis of the W-questions. Until the arrival of the rescue service, the affected person should be taken out of reach of the poisonous substance and provided with oxygen. However, attempts at artificial respiration should be avoided for reasons of self-protection. Instead, the victim – if conscious – should drink as much as possible and keep his upper body elevated. If possible, gastric lavage should be performed directly on site. Under no circumstances should the affected person be made to vomit on his own authority, as the gasoline may enter the trachea or damage the esophagus. If the affected person is unconscious, he must be placed in the recovery position. If breathing stops, cardiopulmonary resuscitation must be initiated until the emergency physician arrives. Further treatment steps then take place in the ambulance and later in the hospital. Afterwards, the main thing for the affected person is to take it easy and to eat a diet that is as low in irritants as possible. Contact with gasoline and other irritants should also be temporarily discontinued.
