Kerosene, a petroleum distillate composed of hydrocarbons, is a common fuel source for lamps, heating, and cooking. Ingestion of this substance is a serious medical emergency requiring immediate professional intervention due to its toxic nature. Its chemical properties make it dangerous upon contact with the body’s internal systems, particularly the lungs. The toxicity is driven by its hydrocarbon components, which can cause significant damage even in small amounts.
The Primary Hazard: Chemical Pneumonitis
The most serious consequence of swallowing kerosene is chemical pneumonitis, a non-infectious inflammation of the lungs. This condition results from the aspiration of kerosene, where the liquid enters the airways and lungs instead of the stomach. Kerosene’s low viscosity, or thinness, and low surface tension allow it to spread rapidly across the surfaces of the airway and alveoli, making aspiration highly likely even during swallowing or vomiting.
Aspiration of less than one milliliter of kerosene can cause serious, potentially life-threatening toxicity in the lungs. Once in the lungs, the hydrocarbon destroys the lipid-rich lining of the alveoli, including the surfactant that keeps the air sacs open. The loss of surfactant leads to the collapse of the air sacs, causing poor lung compliance and respiratory distress. Symptoms of aspiration often begin quickly, within minutes to one hour of ingestion, and include coughing, choking, rapid breathing, and wheezing.
The lung damage progresses as the kerosene causes inflammation, intra-alveolar hemorrhage, and necrosis of the lung tissue. A person may exhibit cyanosis, a bluish discoloration of the skin and mucous membranes, due to the lack of oxygen in the blood. Respiratory symptoms typically worsen over the first six hours and may progress up to 48 hours.
Systemic Effects on Organs and the Central Nervous System
While aspiration is the primary danger, kerosene that is absorbed through the gastrointestinal tract and into the bloodstream causes systemic toxicity, affecting other organ systems. Ingestion initially irritates the mucous membranes of the stomach and intestines, leading to gastrointestinal symptoms such as nausea, vomiting, abdominal pain, and diarrhea. Vomiting significantly increases the risk of aspiration into the lungs.
Once absorbed, the hydrocarbons can affect the central nervous system (CNS), which is rich in lipid-containing myelin sheaths. The lipophilic nature of kerosene allows it to dissolve these lipids, resulting in CNS depression. Acute effects include headache, dizziness, drowsiness, confusion, and euphoria, which can progress to poor ventilatory drive, convulsions, or coma in large ingestions.
Systemic absorption can also lead to delayed damage in other organs. Kerosene exposure has been associated with toxicity to the liver and kidneys, potentially causing cellular and degenerative changes. The heart muscle may also become sensitized to the body’s own stress hormones, leading to cardiac arrhythmias and other heart rhythm problems.
Immediate Emergency Protocol
The immediate action following kerosene ingestion is to contact emergency medical services or a local Poison Control Center. The national toll-free Poison Help hotline provides expert guidance on managing the exposure. This initial call should be made before attempting any home treatment, as specific instructions will be provided based on the individual’s condition.
Avoid inducing vomiting under any circumstances, as this action dramatically increases the risk of fatal aspiration. Vomiting forces the liquid back up the esophagus, making it more likely to enter the open airway. Do not give the person anything to eat or drink unless specifically instructed by a medical professional or Poison Control.
While waiting for emergency personnel, monitor the person’s breathing and consciousness closely, keeping them calm. If the kerosene has contaminated clothing or skin, it should be removed immediately. The affected skin or eyes should be flushed with copious amounts of water for at least 15 minutes. Moving the individual to fresh air is necessary if they have inhaled the kerosene vapors.
Hospital Care and Recovery
Once the patient arrives at a medical facility, treatment focuses on managing symptoms and preventing further complications. Medical staff will assess and monitor the patient’s vital signs, including heart rate, breathing rate, and oxygen saturation. For patients exhibiting respiratory distress, supplemental oxygen will be provided immediately to support lung function.
Diagnostic tools like a chest X-ray and pulse oximetry determine the extent of chemical pneumonitis. Blood tests check for systemic effects, such as acidosis or electrolyte abnormalities. If breathing is compromised or consciousness is decreased, a tube may be placed through the mouth into the windpipe (intubation) to connect the patient to a mechanical ventilator.
Patients who remain asymptomatic and have normal vital signs are typically observed for a period of six hours before discharge. Anyone who develops respiratory symptoms or other signs of toxicity will be admitted for continued monitoring and supportive care. Complete recovery from non-fatal pneumonitis usually occurs within about one week, though the prognosis depends heavily on the amount of kerosene aspirated and the speed of medical intervention.