May is National Barbecue month. The aroma of a steak sizzling on the grill tantalizes the taste buds. Perhaps it is chicken, vegetables or even grilled fruit. Add some side dishes, family and friends and let the good times roll. Some use gas grills, others Instant Light Briquettes but the true champion of the grill uses old fashion charcoal which requires lighter fluid so what could go wrong?
The Lighter fluid is sitting beside the grill. The two-year-old picks it up and drinks some. The child coughs for a moment. If the child has persistent coughing or vomits over the next four hours, take the child to the Emergency Department for evaluation. Lighter fluid is a hydrocarbon which is an aspiration risk. The greatest risks are hydrocarbons with low viscosity such as petroleum and gasoline. Aspiration can cause a chemical pneumonitis. If ingested and there is no aspiration, these may cause a bit of a loose stool later but there is not a systemic toxicity risk. So, we want this ingested hydrocarbon to stay in the gut. It will pass.
At the backyard BBQ there are also Tiki torches which give festive lighting to this outdoor event. Tiki torch fuel is also a hydrocarbon. Another child finds this fuel, picks it up and takes a big swallow, spilling it everywhere but has continuous coughing and choking and even vomits a time or two. The coughing is persistent. The poison center is called and the child is referred in to the Emergency Department for evaluation. The child is coughing and now wheezing. Chemical pneumonitis is certainly possible. A CXR will be ordered. If the respiratory symptoms continue, the child will be admitted for continued evaluation and treatment.
And before the big festivities began, the homeowner wanted to make the yard look nice but was out of gasoline for the lawnmower. Some gas was siphoned from the car so that the yard could be cut but in the process he swallowed a big mouthful which made him cough. “Thought I was going to vomit” was what he told the poison specialist. “Should I make myself throw up?” No, the gasoline which is a hydrocarbon is an aspiration risk if it is vomited back up. Don’t eat or drink for a half hour or so. You may have some diarrhea later. Do not smoke until tomorrow. You will likely burp the smell of gasoline for up to 24 hours. If you continue to have persistent coughing or throw up a couple of times go to the Emergency Room for evaluation.
Eat, drink and be merry; enjoy time with family and friends but watch out for these hidden hazards at your backyard Barbecue.
Reference: Lange, Poisoning and Drug Overdose. McGraw – Hill; USA (2004).
This question prepared by: Denese Britt, BSN, MS, CSPI (Certified Specialist in Poison Information) Tennessee Poison Center
As stated, many petroleum distillates are hydrocarbons with aspiration potential. Any child who is symptomatic following ingestion needs to be evaluated by a physician./ds
I am interested in any questions you would like answered in the Question of the Week. Please email me with any suggestion at donna.seger@vanderbilt.edu
Donna Seger, MD
Medical Director
Tennessee Poison Center
Poison Help Hotline: 1-800-222-1222