Camphor toxicity: development of a triage strategy

Camphor remains in over 950 products listed in Poisindex. To provide triage guidelines for gastric decontamination and referral, we reviewed all camphor ingestions estimated to be 2 mg/kg or greater reported to U. VA (1980-83) and to M.C.V. (1982-83). Seventy-three patients (90%) remained asymptomatic, 3 (4%) developed minor symptoms, and 5 (6%), all ingesting over 59 mg/kg, developed major symptoms. There were no deaths. (table; see text) A literature review of 63 evaluable cases revealed 6 deaths; the mean fatal dose was 199 mg/kg (range 64-570, median 113). Based on these data, we manage asymptomatic patients ingesting camphor at less than 10 mg/kg by observation only 10-30 mg/kg at home with 1 g/kg activated charcoal or emesis, and over 30 mg/kg by gastric decontamination plus referral.