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case report | DOI: https://doi.org/10.31579/2692-9392/133
1 Department of Emergency Medicine, Rowan University SOM/Jefferson - Stratford, NJ.
2 Program Director, Emergency Medicine, Jefferson NJ/Rowan University SOM, Stratford, NJ.
3 Independent researcher, Voorhees, NJ, 08043.
*Corresponding Author: James Espinosa MD, Department of Emergency Medicine Rowan University SOM /Jefferson University NJ 18 East Laurel Road Stratford, NJ 08084.
Citation: Espinosa J, Lucerna A, Hertz R APN. (2022) Case Report: Cold Thermal Injury and Syncope from Pressurized Dust Cleaning Spray. J. Archives of Medical Case Reports and Case Study, 6(1); DOI:10.31579/2692-9392/133
Copyright: © 2022 James Espinosa, This is an open access article distributed under the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 11 June 2022 | Accepted: 17 June 2022 | Published: 24 June 2022
Keywords: syncope from dust cleaning spray; cold thermal injury from dust cleaning spray
Here we present the case of a 21-year -old patient who huffed pressurized dust cleaning spray with subsequent syncope and cold thermal injury to her hands. Air spray cleaners contain halogenated gas, which serves as a propellent to blow dust from electrical and computer devices. The halogenated compound can cause euphoria and can be used as an inhaled abused substance. Use of such substances can be associated with syncope, sudden death, hypoxia and cold thermal injuries. Airway swelling has been reported. Orofacial and digital frostbite has been described as a clue to the detection of the use of such inhalants. An awareness of the association of halogenated gas with syncope and of the possibility of cold thermal injury can be very useful to the clinician.
The halogenated compound can cause euphoria and can be used as an inhaled abused substance. Air spray cleaners contain halogenated gas, which serves as a propellent to blow dust from electrical and computer devices.[1] The halogenated compound can cause euphoria and can be used as an inhaled abused substance. Such substances can be used by direct inhalation (sniffing) or through inhalation from a saturated cloth or paper bag-- (huffing/bagging).Inhalation (huffing) of air duster can occur in any age group. It is more common in teenagers and adolescents. [2-4] The propellant in air duster is generally 1,1-Diflouroethane (DFE). Some dusting sprays contain triflouroethane. This compound has been associated with syncope, arrhythmias and even sudden death. [3,5] The results can include significant morbidity and even mortality. Two associated medical problems are discussed in this case—syncope and cold thermal injury.
A 21-year old-female was brought the emergency department (ED) by emergency medical services (EMS), having been found in a public restroom with a decreased level of consciousness. Two cans of pressurized computer cleaning spray were found with a paper bag and some cloth handtowels. The patient became alert in the ED. She reported huffing the computer cleaning spray and recalled at least two episodes of syncope. Examination of the can showed that the dusting spray contained diflouroethane. She complained of bilateral hand pain. She denied any other complaints. She was not taking any medications. She denied suicidal ideation. She admitted to a two year history of huffing of computer cleaning spray, sometimes from a paper bag and sometimes through direct inhalation. Her vital signs were within normal limits. On physical exam, deep second degree burns were noted of both palms. Her physical exam was otherwise within normal limits. Basic laboratory studies were within normal limits. Her ECG showed a sinus rhythm with no acute ST-T abnormalities. After consultation with a burn center, the patient was transferred for further management.
The mechanism of a halogenated gas associated arrhythmia has been shown in animal studies to be sensitization of the myocardium to catecholemines, probably due to the halogenated hydrocarbon moeity of DFE. [5,6] Inhalation abuse can cause angioedema3 . If a tightly fitting bag is placed over the head with huffing, anoxia can result. [5] Cold thermal injury has been described in association with DFE containing inhalants. [1] The rapid release of pressurized gas causes a cooling effect on the can. Orofacial and digital frostbite has been described as a clue to the detection of the use of such inhalants. [7] Sweating in associated with hydrocarbon use has been hypothesized to allow deeper penetration of the cold injury to the skin. [8] Inhalants, such as 1,1-Diflouroethane containing products, are considered to be addictive. They can cause a sense of euphoria. [4-5] They are inexpensive Open Access Case Report Archives of Medical Case Reports and Case Study James Espinosa * AUCTORES Globalize your Research Archives of Medical Case Reports and Case Study Copy rights @ James Espinosa, et all Auctores Publishing LLC – Volume 6(1)-133 www.auctoresonline.org ISSN: 2692-9392 Page 2 of 2 and readily available. Volatile substance abuse is noted to be most common in males between the ages of 14 and 22 years of age. [7,9] Inhaled hydrocarbons are absorbed through the lungs and exert are readily absorbed by lipids in the brain [6]. Inhalants can affect multiple central neurotrasmitters.[2] Treatment is basically supportive. An awareness of the association of halogenated gas with syncope and of the possibility of cold thermal injury can be very useful to the clinician.
Air spray cleaners contain halogenated gas, which serves as a propellent to blow dust from electrical and computer devices. The halogenated compound can cause euphoria and can be used as an inhaled abused substance. The rapid release of pressurized gas causes a cooling effect on the can. Orofacial and digital frostbite has been described as a clue to the detection of the use of such inhalants. An awareness of the association of halogenated gas with syncope and of the possibility of cold thermal injury can be very useful to the clinician.
Conflict of Interest: There was no funding related to this case report. The authors declare that they have no conflicts of interest.
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