Trifluoromethane

CAS RN:75-46-7

Treatment Overview

0.4.2 ORAL EXPOSURE
  • A) MANAGEMENT OF MILD TO MODERATE TOXICITY
    • 1) Treatment is primarily supportive with removal from source, appropriate decontamination and oxygen administration.
  • B) MANAGEMENT OF SEVERE TOXICITY
    • 1) Remove patient from exposure, decontaminate, and administer oxygen. Aggressive airway management for patients with respiratory or mental status depression should be instated along with supportive measures for hypotension. Administer nebulized bronchodilators (eg, albuterol) for respiratory irritation or bronchospasm. Consider surfactant administration (80ml/m(
    • 2) divided into 4 aliquots given every 12 hours through the endotracheal tube using four positions-left decubitus, head-up then down, right decubitus, head-up then down) for patients with a severe pneumonitis requiring intubation. Treat tachydysrhythmias with esmolol 0.025 to 0.1mg/kg/min IV. Cardiovert unstable ventricular dysrhythmias. Consider early ECMO for pediatric patients with severe pneumonitis. Consider N-acetylcysteine for severe liver injury.
  • C) DECONTAMINATION
    • 1) PREHOSPITAL: Prehospital GI decontamination is not recommended.
    • 2) HOSPITAL: There are very few reports of ingestion of these products, but one resulted in gastric perforation. GI decontamination is generally not indicated.
  • D) AIRWAY MANAGEMENT
    • 1) Patients with CNS or respiratory depression or hemodynamic instability should be intubated.
  • E) ANTIDOTE
    • 1) There is no antidote for fluorinated hydrocarbons.
  • F) ENHANCED ELIMINATION PROCEDURE
    • 1) There is no evidence to support hemodialysis, hemoperfusion, diuresis or multi-dose activated charcoal.
  • G) PATIENT DISPOSITION
    • 1) HOME CRITERIA: Instate home management only if patient is asymptomatic, exposure was minimal and there is no suspicion for self-harm.
    • 2) OBSERVATION CRITERIA: Observe all patients until completely asymptomatic.
    • 3) ADMISSION CRITERIA: Admit any patient with altered mental status, hemodynamic instability, history of an intentional ingestion, suspected or known significant overdose or high pressure digit injury.
    • 4) CONSULT CRITERIA: Involve a toxicologist or poison center immediately if there is concern for intentional or significant overdose. Consult an orthopedic surgeon if there is concern for a high pressure digit injury. Consult ophthalmology if corneal injury is suspected and involve a burn surgeon as needed.
  • H) PITFALLS
    • 1) Appropriate therapy may be delayed due to failure to refer to a material safety data sheet for chemical information and failing to recognize a high pressure digit injury. Beware of secondary exposures that may come from rescuers who were also exposed to compounds within an enclosed setting.
  • I) TOXICOKINETICS
    • 1) These agents are rapidly absorbed by the lungs, with a nearly immediate onset of action. Primary elimination is via exhaled breath.
  • J) DIFFERENTIAL DIAGNOSIS
    • 1) It is important to also consider symptoms of toxicity may be due to volatile hydrocarbons (gasoline and toluene), alkyl nitrites (amyl nitrite), and/or nitrous oxide.
0.4.3 INHALATION EXPOSURE
  • A) MANAGEMENT OF MILD TO MODERATE TOXICITY
    • 1) Treatment is primarily supportive with removal from source, appropriate decontamination and oxygen administration.
  • B) MANAGEMENT OF SEVERE TOXICITY
    • 1) Remove patient from exposure, decontaminate, and administer oxygen. Aggressive airway management for patients with respiratory or mental status depression should be instated along with supportive measures for hypotension. Administer nebulized bronchodilators (eg, albuterol) for respiratory irritation or bronchospasm. Consider surfactant administration (80ml/m(
    • 2) divided into 4 aliquots given every 12 hours through the endotracheal tube using four positions-left decubitus, head-up then down, right decubitus, head-up then down) for patients with a severe pneumonitis requiring intubation. Treat tachydysrhythmias with esmolol 0.025 to 0.1mg/kg/min IV. Cardiovert unstable ventricular dysrhythmias. Consider early ECMO for pediatric patients with severe pneumonitis. Consider N-acetylcysteine for severe liver injury.
  • C) AIRWAY MANAGEMENT
    • 1) Patients with CNS or respiratory depression or hemodynamic instability should be intubated.
  • D) ACUTE LUNG INJURY
    • 1) Supplemental oxygen; PEEP and mechanical ventilation may be needed.
0.4.4 EYE EXPOSURE
  • A) DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.
  • B) Perform a slit lamp exam.
  • C) Ophthalmologic consultation should be considered in symptomatic patients.
0.4.5 DERMAL EXPOSURE
  • A) OVERVIEW
    • 1) DECONTAMINATION: Remove contaminated clothing and jewelry and place them in plastic bags. Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).
    • 2) If frostbite has occurred, refer to dermal treatment in the main body of this document for rewarming.
    • 3) If a high pressure injury is suspected, consult an orthopedic surgeon.
    • 4) Consult a burn surgeon as needed.
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