Methane toxicity: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
===History=== | |||
*Confined space, particularly at work | |||
**Mining | |||
**Large scale animal farming | |||
**Fossil fuel industry | |||
**Organic decomposition | |||
*Other people exposed may have similar symptoms | |||
===Symptoms=== | |||
*Wide range, nonspecific | *Wide range, nonspecific | ||
**Tachycardia | **Tachycardia | ||
| Line 18: | Line 27: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Methemoglobinemia]] | *[[Methemoglobinemia]] | ||
*[[High altitude medicine|Altitude related illness]] | *[[High altitude medicine|Altitude related illness]] | ||
*Primary CNS disease | *Primary CNS disease | ||
*ACS | *[[ACS]] | ||
{{Toxic gas exposure DDX}} | |||
==Evaluation== | ==Evaluation== | ||
===Workup=== | ===Workup=== | ||
*Oxygen saturation - decreased, should improve with removal from exposure | *Oxygen saturation - decreased, should improve with removal from exposure | ||
*No definitive test for methane | *No definitive test for methane | ||
*Consider other diagnostic testing to rule out other causes if unsure exposure or lack of improvement: | *Consider other diagnostic testing to rule out other causes if unsure exposure or lack of improvement: | ||
**EKG | **[[EKG]] | ||
**CXR | **[[CXR]] | ||
**Head CT | **[[Head CT]] | ||
**ABG | **[[ABG]] | ||
**Carboxyhemoglobin | **Carboxyhemoglobin | ||
===Diagnosis=== | ===Diagnosis=== | ||
*Clinical/diagnosis of exclusion | *Clinical/diagnosis of exclusion | ||
| Line 48: | Line 50: | ||
==Management== | ==Management== | ||
*Supplemental oxygen | *Supplemental [[oxygen]] | ||
*Other supportive care as indicated | *Other supportive care as indicated | ||
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*Kuschner WG, Blanc PD. Kuschner W.G., & Blanc P.D. Kuschner, Ware G., and Paul D. Blanc.Gases & Other Airborne Toxicants. In: LaDou J, Harrison RJ. LaDou J, & Harrison R.J.(Eds.),Eds. Joseph LaDou, and Robert J. Harrison.eds. CURRENT Diagnosis & Treatment: Occupational & Environmental Medicine, 6e. McGraw Hill; 2021. | *Kuschner WG, Blanc PD. Kuschner W.G., & Blanc P.D. Kuschner, Ware G., and Paul D. Blanc.Gases & Other Airborne Toxicants. In: LaDou J, Harrison RJ. LaDou J, & Harrison R.J.(Eds.),Eds. Joseph LaDou, and Robert J. Harrison.eds. CURRENT Diagnosis & Treatment: Occupational & Environmental Medicine, 6e. McGraw Hill; 2021. | ||
<references/> | <references/> | ||
[[Category:Toxicology]] | |||
Latest revision as of 03:55, 27 November 2021
Background
- Simple asphyxiant
- Inert gases that displace oxygen and decrease FiO2
- Lighter than air
- Explosive
- Natural production by bacteria in GI tract of humans, other animals
Clinical Features
History
- Confined space, particularly at work
- Mining
- Large scale animal farming
- Fossil fuel industry
- Organic decomposition
- Other people exposed may have similar symptoms
Symptoms
- Wide range, nonspecific
- Tachycardia
- Tachypnea
- Headache
- Confusion
- Nausea/vomiting
- LOC
- Coma
- Cardiac arrest
Differential Diagnosis
- Methemoglobinemia
- Altitude related illness
- Primary CNS disease
- ACS
Toxic gas exposure
- Carbon monoxide toxicity
- Chemical weapons
- Cyanide toxicity
- Hydrocarbon toxicity
- Hydrogen sulfide toxicity
- Inhalant abuse
- Methane toxicity
- Smoke inhalation injury
- Ethylene dibromide toxicity
Evaluation
Workup
- Oxygen saturation - decreased, should improve with removal from exposure
- No definitive test for methane
- Consider other diagnostic testing to rule out other causes if unsure exposure or lack of improvement:
Diagnosis
- Clinical/diagnosis of exclusion
- Often based on history of exposure
Management
- Supplemental oxygen
- Other supportive care as indicated
Disposition
- Discharge
- If stable vitals, improved mental status, and otherwise asymptomatic
- Admit
- If needed for further supportive care
See Also
External Links
References
- Kuschner WG, Blanc PD. Kuschner W.G., & Blanc P.D. Kuschner, Ware G., and Paul D. Blanc.Gases & Other Airborne Toxicants. In: LaDou J, Harrison RJ. LaDou J, & Harrison R.J.(Eds.),Eds. Joseph LaDou, and Robert J. Harrison.eds. CURRENT Diagnosis & Treatment: Occupational & Environmental Medicine, 6e. McGraw Hill; 2021.