A case study in metabolic acidosis induced by inhalation

Our program was requested to transport a 15-year-old boy weighing approximately 100 kilograms from a clinic to a tertiary pediatric intensive care unit. The initial diagnosis from dispatch was for respiratory difficulties. When the flight crew arrived at the clinic, they were informed that the patient had been "huffing" carburetor cleaner for the preceding 12 hours. The patient presented to the clinic after 5 hours of protracted vomiting with rapid respirations.