Acute exposure

Inhalation

The victim should be removed from exposure and all contaminated clothing removed. The respiratory function should be assessed. Further treatment is symptomatic and supportive. See below for management of systemic effects.

Dermal

Contaminated clothing should be removed and the skin thoroughly irrigated with water or saline. Further treatment is symptomatic and supportive. See below for management of systemic effects.

The eyes should be thoroughly irrigated with water or saline for 15 minutes and then stained with fluorescein. Referral to an ophthalmologist is recommended if there is any uptake of fluorescein.

Ingestion

Gastric lavage is not indicated following ingestion of isopropanol, as it is quickly absorbed by the gut. Activated charcoal is not of benefit. If there has been any vomiting, coughing or wheezing in a patient with altered mental status, then the patient will need to be assessed to determine if aspiration has occurred. Treatment is supportive. See below for management of systemic effects.

Toxicology of Solvents Systemic effects

Close monitoring of the patient's respiration is required because of the risk of respiratory depression. In severe cases electrolytes, creatinine, glucose, full blood count, arterial blood gases, serum acetone and isopropanol, renal and liver function should be monitored. Hypotension should be treated with intravenous fluids and ionotropes if necessary. Deep coma and refractory hypotension are indications for haemodialysis or peritoneal dialysis; this should also be considered in patients with an isopropanol level greater than 4,000 mg/l (Lacouture et al., 1983).

The presence of non-acidotic acetonaemia and acetonuria are key factors allowing the differentiation of isopropanol from ethanol intoxication, diabetes mellitus, starvation and cyanide poisoning (Agarwal, 1979; Lacouture et al., 1983).

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