title: Unintentional Pediatric Ingestion of Electronic Cigarette Nicotine Refill Liquid Necessitating Intubation.
abstract: Liquid nicotine used in electronic cigarette devices is highly concentrated, unreliably packaged, and poorly regulated. We present a case report of a 6-year-old female who developed severe toxicity and required intubation after an unintentional oral ingestion of approximately 703 mg (35 mg/kg) of liquid nicotine, with accompanying serum and urine concentrations of nicotine and its metabolites. Analysis of the ingested liquid suggests a nicotine concentration of 140.6 mg/mL in the purchased commercial product, or 234% of its labeled concentration. Clinicians should be aware of these products and the potential severity of toxicity they may incur.
authors.affiliation: Department of Emergency Medicine, Oregon Health and Science University, Portland, OR. Electronic address: nobelm@ohsu.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Noble
authors.affiliation: Department of Emergency Medicine, Oregon Health and Science University, Portland, OR.
authors.forename: Beck
authors.initials: B
authors.lastname: Longstreet
authors.affiliation: Department of Emergency Medicine, Oregon Health and Science University, Portland, OR.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hendrickson
authors.affiliation: Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California at San Francisco, San Francisco, CA.
authors.forename: Roy
authors.initials: R
authors.lastname: Gerona
mesh_terms: D002648:Child; D062787:Drug Overdose / Q000628:therapy*; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D009538:Nicotine / Q000097:blood / Q000506:poisoning* / Q000652:urine
chemical_list: D009538:Nicotine