title: Carbon monoxide poisoning and pulmonary injury from the mixture of formic and sulfuric acids.
abstract: BACKGROUND
  The inhalation of carbon monoxide produced by the incomplete combustion of carbon remains a popular method of suicide. A much less common method of producing carbon monoxide for suicide is by mixing formic and sulfuric acids.
  
  
  METHODS
  We describe a patient who attempted suicide by mixing formic and sulfuric acids. He presented with a depressed level of consciousness, chemical burns of his airway and skin, and respiratory distress. He was found to have a metabolic acidosis, a carboxyhemoglobin of 36.8%, hyperkalemia, and rhabdomyolysis. His hospital course was notable for copious pulmonary secretions and hypoxia, but he ultimately recovered with supportive care.
  
  
  CONCLUSIONS
  The case highlights the potential toxicity, particularly from inhaled carbon monoxide and formic acid, with this method of suicide.
authors.affiliation: a Division of Medical Toxicology, Department of Emergency Medicine , University of California, San Diego Health System , San Diego , CA , USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Schneir
authors.affiliation: a Division of Medical Toxicology, Department of Emergency Medicine , University of California, San Diego Health System , San Diego , CA , USA.
authors.forename: Landen
authors.initials: L
authors.lastname: Rentmeester
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D002057:Burns, Chemical / Q000175:diagnosis; D002249:Carbon Monoxide Poisoning / Q000150:complications / Q000175:diagnosis*; D002263:Carboxyhemoglobin / Q000378:metabolism; D005561:Formates / Q000506:poisoning*; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced; D055370:Lung Injury / Q000139:chemically induced*; D008297:Male; D012206:Rhabdomyolysis / Q000139:chemically induced; D013406:Suicide, Attempted; D013464:Sulfuric Acids / Q000506:poisoning*
chemical_list: D005561:Formates; D013464:Sulfuric Acids; C030544:formic acid; D002263:Carboxyhemoglobin
keywords: Carbon monoxide; carboxyhemoglobin; chemical pneumonitis; rescuer; suicide