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The death of a teenager shows the danger of snooping, snorting to get high



(Reuters Health) – The death of a Dutch teenager serves as a bleak reminder of the dangers of inhaling common household products such as spray-on deodorants, wipers, and whipped cream. The 19-year-old cardiac arrest and his death were described in an article published in BMJ Case Reports.

"The use of volatile substances in everyday household products is very low in the general population, but most perpetrators belong to a group of people to whom we should pay particular attention as a society: Adolescents from adolescents in difficulty Households, "said the lead author of the study. Kelvin Harvey Kramp from the Maasstad Hospital in Rotterdam. "Medical personnel who are unfamiliar with the use of inhalants can be confronted with dramatic consequences such as cardiac arrest."

According to the National Institute on Drug Abuse, 1

00 to 200 deaths each year are due to inhalation abuse in the United States. Cardiac arrests after inhalation abuse are so common that they have been given a name: "sudden cold of death".

Inhalers of abuse use one of three methods to absorb the volatile substances that give them a short noise potential: direct inhalation as sniffing; Inhale through a piece of cloth known as wheeze; and packing in which the substance is inhaled through a plastic bag or balloon.

Hydrocarbons used in home sprays for aerosol sprays are the cause of the short-lived high. These substances readily dissolve in fat, "and thus easily cross the pulmonary and cerebral blood barriers and dissolve in high-fat tissues such as the liver. For example, the nervous system, "explained Kramp.

Once they have crossed the blood-brain barrier, they "disrupt normal brain processes," Dr. Michael Lynch, medical director of the Pittsburgh Poison Center at the University of Pittsburgh Medical Center in Pennsylvania, who was not involved in the case report.

"People are feeling high and can pass out," Lynch said. "You may feel excited, happy or stupid. The effect usually takes a few minutes. Then people do it again or go on with their day.

Cardiac arrest may occur because inhaled propellants "sensitize your heart," Lynch said. "They make your heart react to adrenaline much faster, so that people can get cardiac arrest when they get agitated or surprised."

The teenager described by Kramp and his colleagues was treated in a drug rehabilitation center for ketamine and cannabis abuse. In an attempt to get up, he put a towel over his head and inhaled the spray from a deodorant can.

He quickly became agitated and hyperactive and then suffered a cardiac arrest. The basic life support by nurses on site and six defibrillation rounds (heartbeat) by paramedics finally revived him. The hospital was admitted to intensive care and placed in a medically induced coma.

While his heart function returned to normal, his brain activity was never the case, the doctors report. For nine days, abnormal brain values ​​and visible jerkiness indicated persistent epileptic seizures.

When his condition did not improve with the treatments and it became clear that no further intervention would help, the doctors separated the teenager from life support.

Ultimately, Kramp explained, the teenager was killed when "the brain went out of oxygen during cardiac arrest. This led to irreparable brain damage. After brain damage, the patient did not have enough brain function to sustain life.

While Dutch authors suggest that inhaled abuse is limited to restless children, Dr. Andrew Stolbach, that this is much more widespread in the US. "I think the number of people either sniffing or hoofing or slumping is probably higher than we think," said Stolbach, a medical toxicologist and emergency physician at the Johns Hopkins Hospital in Baltimore, Maryland. "I'd bet many kids do that who do not have access to other drugs."

With this statement: "Not many people die of it," remarked Stolbach. "It's not on the scale of opioids or alcohol, but it does happen, I learned about it when I was trained as a medical toxicologist, in hospitals you do not see much of it, but it seems reasonable, I'm in the suburbs grown up and many kids would do that but the true number is unknown.For kids it seems harmless fun because it involves something they are familiar with and they tend to think about things that are around us – Everyday items that we see in the garage or in the bathroom – as safe. "

The new article should also remind Stolbach how important cardiopulmonary resuscitation (CPR) is." If you are someone with no pulse the faster you can start resuscitation, "he said.

SOURCE: bit.ly/Tm4RMr BMJ Case Reports, online November 15, 2018.

Our Standards: The Thomson Reuters Trust Principles.

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