Ethylene dibromide toxicity

Background

• Volatile liquid used in leaded gasoline and pesticides

Mechanism of Toxicity

• Irritant, with potential to cause chemical burns
• Respiratory tract irritation if inhaled
• Metabolites irreversibly bind to DNA and enzymes

Clinical Features

• Pulmonary edema
• Respiratory tract irritation
• Eye irritation
• Local swelling, inflammation with skin exposure
• Diarrhea
• Vomiting
• Coma
• Seizures
• Rhabdomyolysis
• Metabolic acidosis

Differential Diagnosis

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

• Based on clinical history
• Specific levels are not useful in the ED

Management

• Decontamination measures
• Administer activated charcoal
• Treat wheezing, obstruction, pulmonary edema
• No role for hemodialysis

See Also

• Hydrocarbon toxicity

References

• Olson, K. Poisoning and Drug Overdose, 1999.