Acute:
(1) skin and inhalation burns from ignition of volatile solvents
(2) freezing injury to the upper airways associated with use of propellants
(3) asphyxia from passing out with a plastic bag wrapped around the head
(4) traumatic injury
(5) cardiac arrhythmias
(6) aspiration pneumonia
(7) methemoglobinemia with nitrites
(8) acute vitamin B12 deficiency with nitrous oxide (see Chapter on Anesthesiology)
Chronic:
(1) lead poisoning
(2) aplastic anemia or leukemia
(3) particulate debris in the lungs or chemical pneumonitis
(4) optic atrophy with blindness
(5) renal failure
(6) hepatic failure
(7) deafness
(8) neurologic defects (peripheral neuropathy, cerebellar atrophy, encephalitis, dementia)
(9) other kinds of drug abuse
(10) HIV infection
(11) psychiatric disturbances
Evaluation of the patient might include:
(1) ENT examination of the mouth, nares, pharynx and airways
(2) eye examination
(3) hearing examination
(4) complete neurologic examination, possibly with a brain CT scan
(5) ECG
(6) chest X-ray
(7) pulmonary function tests with or without blood gases
(8) complete blood count
(9) liver panel of laboratory tests
(10) renal panel of laboratory tests
(11) vitamin B12
(12) lead levels
(13) HIV antibodies
(14) screen for drugs of abuse
(15) methemoglobin levels
