Killing Brain Cells and Skin Cells Simultaneously with Inhalant Abuse: Pearls from the National Burn Repository

Abstract

Over 20 million Americans have abused inhalants at least once in their lifetime. It is widely known that "huffing" increases risk for liver disease, renal failure, hypoxia, respiratory failure, dysrhythmias, and cardiac arrest. However, it is lesser known that inhalants can also cause thermal or frostbite injury. This study is a review of 2003 to 2012 National Burn Repository (NBR) records with a query for "huff," "inhalant," and corresponding ICD-9 codes. The NBR represents the cumulative data of subjects presenting to regional burn centers throughout the nation. Twenty-eight cases of inhalant injury were found. Approximately one-third were due to frostbite secondary to cold liquids exiting aerosol cans. The remaining two-third were due to thermal injury when the flammable solvent ignited. Median burn size was 3% total BSA (TBSA). Eight patients suffered inhalation injuries and one patient died. Although the median burn size of these patients was relatively small, some had significant injuries requiring long hospital length of stay. Direct costs of healthcare and indirect costs of lost wages make inhalant injury a significant public health problem. Multidisciplinary governmental efforts should be focused on prevention, education, recognition, and early intervention when inhalant abuse is suspected.