Routine laboratory studies in all exposed patients included CBC, glucose, and electrolyte assays. In the case of high exposure, other useful studies include ECG monitoring, determination of carboxyhemoglobin levels, and liver function testing. For severe inhalation exposure or suspected pulmonary inhalation, a chest X-ray and pulse oximeter (or ABG measurement) are recommended. Blood dichloromethane levels are not clinically useful; However, they can be used to qualitatively document exposures. The level of carboxyl hemoglobin in exposed patients rarely exceeds 15%, but may remain elevated for 1 to 2 days after exposure due to continued metabolic conversion of dichloromethane from fat storage.
Disposal and follow-up
Consider hospitalization for symptomatic patients with suspected severe exposure and symptoms.
Delayed effect
In severely exposed patients, arrhythmias and skin burns may occur several hours after exposure. Exposure to large amounts of dichloromethane (dichloromethane sds) Blood dichloromethane levels are not clinically usefulmay lead to increased blood concentrations of its metabolite carbon monoxide. This can lead to permanent after-effects, including mental deterioration, incontinence and gait disorders. However, most cases of delayed neurological sequelae are associated with loss of consciousness during the acute phase of poisoning.
Patient release
Patients who do not experience breathing difficulties or altered mental status can be discharged. Patients with mild initial symptoms but no symptoms 6 to 12 hours after exposure can also be discharged. If symptoms occur or relapse, discharged patients should be advised to rest and seek prompt medical attention (see methylene chloride patient Information sheet). Patients should not be discharged based on carboxy-hemoglobin levels alone, as oxygen therapy may make carboxy-hemoglobin levels unreliable. Metabolic conversion of dichloromethane to carbon monoxide may be ongoing, and carboxyl hemoglobin levels may rebound after oxygen therapy is stopped.
