Management overview for essential oil poisoning

Essential oils include any plant-derived volatile oil that contains the ‘essence’ or distinctive aroma of the plant. A wide variety of essential oils are available including camphor, citronella, clove, eucalyptus, pennyroyal, tea-tree, wintergreen and many other aromatherapy oils. Essential oils are available as vaporiser solutions, which are less concentrated (eg 20 to 25% concentrations). Eucalyptus oil is the most common essential oil poisoning.

Toxicity varies depending on the dose and the essential oil ingested. Most poisonings occur in children, who have minor effects or remain asymptomatic. However, large ingestions can cause rapid onset of seizures, central nervous system (CNS) depression and aspiration pneumonitis. Clove or pennyroyal oil ingestions may cause multiorgan failure, including acute liver injury.

For management of oil of wintergreen (98% methyl salicylate) ingestion, see Aspirin and other salicylate poisonings. For any ingestion of clove or pennyroyal oil, urgently contact a clinical toxicologist or poisons information centre (13 11 26). For other essential oil ingestions, supportive care is the mainstay of treatment.