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Objective: Experience with glycol ether poisoning in humans is limited. The goal of this study was to characterize all glycol ether ingestions reported to a regional poison center over a 5-year period. Methods: A retrospective review of all records from a regional poison center (annual volume: 47,000 human exposure calls/year) of glycol ether ingestions was performed for the period 1994-1998, inclusive. Data recorded included: patient age, ingested product, estimated concentration and amount of glycol ether, symptoms, evaluation and outcome. Results: 279 cases of glycol ether ingestion were identified. Median patient age was 2 years (range: 7 weeks to 63 years). 173 (62%) of patients were less than 3 years of age. Ingested agents included 5 chemical formulations containing glycol ether in various concentrations, and 37 products reported only as 'glycol ether.' Medical evaluation at a health care facility was sought in 18 cases. In only 13 cases (5%) did the victim ingest more than 15 mL of the agent. The greatest amount ingested was 200 mL of a low-concentration ethylene glycol butyl ether in a suicide attempt. This patient was the only one in the series hospitalized for observation secondary to abdominal pain. The majority of patients 108 (71%) were asymptomatic. Vomiting/gagging, oropharyngeal irritation, and bad taste were the most commonly reported symptoms. Conclusions: From our series of 279 glycol ether ingestions, no serious clinical manifestations were observed. The majority of patients were under 3 years of age and experienced ingestions of less than 15 mL of glycol ether compounds., McDonald J, Turner J, Bosse G, Spiller H. Department of Pediatrics, Division of Pediatric Emergency Medicine, Utah; Southwestern Medical Center, Dallas, Texas, Department of Emergency Medicine, University of Louisville and [...]

Background: We present an unusual case of oral halothane ingestion resulting in acute liver failure. Case Report: A 29-year-old male with a history of bipolar disorder and alcoholic liver disease presented to the emergency department (ED) 5 days after hosting a party where the participants were 'huffing halothane'. He denied using halothane personally. He also denied alcohol use for the past 5 years. The following morning he awoke to take his morning dose of gabapentin, drank approximately 2.5 ounces of a clear liquid he thought was water, realized it was halothane and immediately began to vomit. Intractable emesis continued for the next 5 days. On presentation to the ED, his temperature was 103.7, heart rate 119, respiratory rate 18, and blood pressure 155/70. Physical exam revealed an obese male in mild distress from emesis and apparent abdominal discomfort. His abdomen was non-distended with no hepatosplenomegaly. He was tender to palpation over the epigastrium. Lab results showed that the ALT was 214 IU/L, with an AST of 201 IU/L. Poison Control recommended supportive care. Since the CXR showed a right middle lobe infiltrate, he was discharged on an oral quinolone. He presented for the second time 3 days later with increased nausea, vomiting, abdominal pain. He admitted to acetaminophen use for fever and discomfort. Lab results showed an AST of 2760 IU/L, ALT of 2347 IU/L, prothrombin time of 18.8 seconds, and a partial thromboplastin time of 41.4 seconds. Toxicology screens were positive for cannabinoids. The acetaminophen level was 18 mcg/mL. The patient was admitted for acute liver failure thought to be secondary to halothane ingestion. The patient left against medical advice on hospital day 2 with AST decreased to 752 IU/L and ALT decreased to 1366 IU/L. Conclusion: Oral halothane ingestion resulting in acute hepatitis is extremely unusual. Treatment is supportive., Langford J, Bosse G. Department of Emergency Medicine, University of Louisville, Louisville, [...]