There are few antidotes to counteract the actions of hydrocarbons. N-Acetyl cysteine16 and hyperbaric oxygen27 may have a role in preventing hepatic toxicity after carbon tetrachloride (and possibly chloroform) exposure, but more studies are needed. Hyperbaric oxygen therapy is indicated for patients who develop significant carbon monoxide toxicity after exposure to methylene chloride. b blockers may be useful in the treatment of hydrocarbon-induced malignant dysrhythmias. 28 Although extracorporeal removal with hemodialysis, hemoperfusion, or peritoneal dialysis has been attempted for severe intoxications, clinically controlled evidence of efficacy is lacking.
The treatment of tar and asphalt injuries is a particular problem because of the difficulty in removing these substances without causing further tissue injury. Immediate cooling with cold water for at least 30 min is critical. Debridement of blistered skin can aid in the removal of adherent substances. De-Solv-It, a surface-active petroleum-based solvent, has proven both nonirritating and effective in removing these agents. 29 Polyoxyethylene sorbitan-containing ointments, such as Polysorbate 80 or Tween 80, have also proven useful. Petrolatum-containing preparations, such as Neosporin (although occasionally sensitizing) or Polysporin, may also work and are readily available. In some instances, early excision and skin grafting are required to treat the more significant hot tar burns.
Undoubtedly, the best therapy begins with preventive measures to reduce accessibility of these compounds to young children. Proper labeling of containers that store hydrocarbons, mandatory use of safety closures, and public education on the risks of hydrocarbons also limit the potential for inadvertent hydrocarbon toxicity.
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