Not all patients who have ingested hydrocarbons require emergency department evaluation. In a retrospective study of 211 patients with hydrocarbon ingestions called to a poison center, fewer than one percent required physician intervention. 9 This data suggests that patients who are asymptomatic or quickly become asymptomatic after ingestion can be watched safely at home. This approach of home observation for asymptomatic patients can be supported when the ingestion is accidental, the ingredients are known and do not cause significant systemic toxicity when ingested, and reliable follow-up can be ensured. All symptomatic patients and intentional exposures should be referred to the hospital for further evaluation. Patients who ingest hydrocarbons that may cause significant systemic toxicity (e.g., aromatic, halogenated hydrocarbons, or toxic additives), whether or not symptomatic, should also be referred to the hospital. Volatile substance abusers and others exposed to volatiles should have immediate cardiac monitoring and advanced life support transport, if available, due to the potential for life-threatening dysrhythmias.
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