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Hydrocarbons are a diverse group of organic compounds consisting
primarily of carbon and hydrogen atoms. The two basic forms of hydrocarbons
are aliphatic (straight- or branched-chain) and cyclic configurations. Halogenated (halogen
group) and aromatic (benzene ring) hydrocarbons are two examples
of aliphatic and cyclic hydrocarbon subclassifications, respectively.
Products containing hydrocarbons are found in many household and
occupational settings (Table 193-1).
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Most hydrocarbons are produced by petroleum distillation, which
results in predominantly aliphatic mixtures of hydrocarbons of different chain
lengths. Chain length and branching determine the phase of the hydrocarbon
at room temperature. Short-chain aliphatic compounds (up to 4 carbons),
such as methane, ethane, propane, and butane, are gases; intermediate-chain
aliphatic compounds (5 to 19 carbons), such as solvents, lamp oil,
lighter fluid, and gasoline, are liquid; and long-chain aliphatic
compounds (>19 carbons), such as waxes, are solids. Liquid hydrocarbons
account for most exposures seen in the emergency department.1
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Exposures to hydrocarbons and volatiles most commonly occur as
ingestions or inhalations. Most hydrocarbon exposures have a benign
clinical course. During 2008, the American Association of Poison
Control Centers’ Toxic Exposure Surveillance System received
reports of 46,418 exposures to hydrocarbons.1 Significant
toxicity was uncommon; only 2267 patients experienced moderate or
major effects. There were 17 deaths where hydrocarbons were mentioned;
13 of which were isolated exposures to a hydrocarbon. Ingestions
were more likely than inhalation to produce serious toxicity. Hydrocarbon
aspiration accounts for 20% of aspiration accidents in
children <5 years of age.2 Pulmonary
symptoms and signs develop in 40% to 50% of the
children who ingest hydrocarbons.3–5 Rare
cases of suicidal injection of gasoline or kerosene with severe
multi-organ toxicity have been reported.6,7
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Volatile solvent abuse most often occurs in teenagers and younger adults,
especially those in lower socioeconomic groups, who abuse volatile
liquid chemicals or gases for the euphoric effects (Table
193-2).8 Hydrocarbons can be abused in different
ways: (1) in “huffing” the individual soaks a
rag with the inhalant and then ...