Management overview for hydrocarbon inhalation

Note: Urgently contact a clinical toxicologist or poisons information centre if hydrocarbon inhalation is suspected.

Inhalation of hydrocarbons generally involves recreational use; activities leading to exposure include ‘sniffing’ (eg glues, marker pens, petrol, paint thinners) or ‘chroming’ (eg aerosol sprays, including paints). Aromatic and halogenated hydrocarbon compounds are most commonly implicated in inhalational misuse (see Common hydrocarbons and clinical effects).

Accidental inhalation of methylene chloride can occur during use of paint stripper for a prolonged period in an unventilated space, which may have the potential to cause carbon monoxide poisoning. Management advice for methylene chloride poisoning is available in both this monograph and the carbon monoxide poisoning monograph.

Inhalational hydrocarbon toxicity is most commonly seen after solvent misuse, and causes central nervous system (CNS) effects. Toxicity depends on the concentration and duration of exposure. It can also cause ‘sudden sniffing death’—cardiorespiratory arrest due to myocardial sensitisation to endogenous catecholamines.

If hydrocarbon inhalation is suspected, urgently contact a clinical toxicologist or poisons information centre (13 11 26). Management of hydrocarbon poisoning is primarily supportive care, including airway protection in comatose patients, and recognition of cardiovascular complications.