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Complications following butane inhalation and flash fire
1Department of Pathology, University of North Carolina Chapel Hill, USA.
Summary
Sudden death can result from volatile substance abuse, even with minor burns. Delayed respiratory complications, like adult respiratory distress syndrome (ARDS), following solvent inhalation can be fatal.
Area of Science:
- Toxicology
- Forensic Pathology
- Pulmonology
Background:
- Volatile substance abuse (VSA) via solvent inhalation is a known cause of drug abuse, potentially leading to euphoria, hallucinations, and sudden death.
- Common causes of sudden death from volatile substances include cardiac arrhythmias, asphyxia, direct drug toxicity, and trauma.
Observation:
- A victim sustained superficial partial thickness burns (12% total body surface area) from a flash fire after inhaling butane in an enclosed vehicle.
- Initial hospital observation for 2 days revealed no respiratory symptoms; however, the victim died during readmission 9 days post-incident.
Findings:
- Postmortem examination revealed extensive epithelial injury from the upper airway to terminal bronchioles.
- The injury was attributed to initial inhalation damage, subsequent adult respiratory distress syndrome (ARDS), and a staphylococcal infection.
Implications:
- Superficial burn victims may not seek medical care due to embarrassment or legal concerns, potentially withholding information about solvent abuse.
- Delayed deaths following volatile substance abuse may occur and go unrecognized, even with thorough investigations.