Acetone

CAS RN: 67-64-1

Treatment Overview

0.4.2 ORAL EXPOSURE
  • A) MANAGEMENT OF MILD TO MODERATE POISONING
    • 1) Generally requires no specific intervention. Administer intravenous fluids and antiemetics as necessary.
  • B) MANAGEMENT OF SEVERE POISONING
    • 1) Administer intravenous 0.9% saline for hypotension or persistent tachycardia. Endotracheal intubation and mechanical ventilation may be required in patients with CNS or respiratory depression. Evaluate for gastrointestinal bleeding after large ingestion.
  • C) DECONTAMINATION
    • 1) EMESIS: Emesis is not recommended because of the potential for CNS depression and subsequent aspiration.
    • 2) Activated charcoal is of limited utility; routine use is not recommended.
    • 3) Consider insertion of a nasogastric tube to aspirate stomach contents only after recent, large acetone ingestions.
  • D) ENHANCED ELIMINATION
    • 1) Hemodialysis enhances clearance of acetone, but is almost never indicated. It may be considered in patients with hemodynamic instability or acidosis not responding to supportive care.
  • E) PATIENT DISPOSITION
    • 1) HOME CRITERIA: Asymptomatic patients with inadvertent exposures to small quantities of household products can be monitored at home.
    • 2) OBSERVATION CRITERIA: Symptomatic patients and those with deliberate or large exposures should be referred to a healthcare facility.
    • 3) ADMISSION CRITERIA: Admit patients with persistent CNS depression, hypotension, persistent tachycardia, or gastrointestinal bleeding to an intensive care setting.
    • 4) CONSULT CRITERIA: Consult a poison center or medical toxicologist for patients with severe manifestations such as coma, hypotension, or gastrointestinal bleeding.
  • F) TOXICOKINETICS
    • 1) Well absorbed orally; dermal and inhalation absorption occur, but rarely cause systemic toxicity. Volume of distribution 0.8 L/kg. Mostly excreted unchanged, primarily by the lungs, to a lesser extent renally. Limited metabolism to acetate and formate. Half life is about 4 hours at low levels of exposure, increases to 19 to 31 hours after large exposures.
  • G) DIFFERENTIAL DIAGNOSIS
    • 1) Diabetic ketoacidosis. Ethanol or isopropanol intoxication.
0.4.3 INHALATION EXPOSURE
  • A) Remove from exposure. Administer oxygen if respiratory distress develops. Treat wheezing or persistent coughing with inhaled beta agonists.
0.4.4 EYE EXPOSURE
  • A) Irrigate eyes with 0.9% saline after splash exposures. Perform a slit lamp exam in patients with persistent irritation. Refer to an ophthalmologist if corneal injury is present.
0.4.5 DERMAL EXPOSURE
  • A) OVERVIEW
    • 1) Remove contaminated clothing and wash exposed skin with soap and water. An emollient cream may provide symptomatic relief in patients with irritation or defatting dermatitis.
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