The hazards of the natural world are not an issue for those of us born into “civilization”. Without lions, tigers, bears, and dingoes to endanger our babies, we’ve had to become more creative. Firearms in the home, detergent packets, and, now: highly concentrated nicotine from e-cigarettes. This short review provides a brief look at an increasingly prevalent health hazard.
The lethal dose of nicotine is approximately 1 mg/kg. Concentrations of liquid nicotine cartridges may be as high as 35 mg/mL. A typical 10 mL refill bottle, then, has easily a lethal dose for children, while a 50 mL bottle could have more than enough to bring down a horse. For comparison, a conventional cigarette contains 10 to 1 5mg of nicotine – certainly a danger, but on a different scale entirely.
The expected clinical effects are consistent with the classical nicotinic and muscarinic toxodromes – vomiting, diarrhea, salivation, bronchorrhea, seizures, rhabdomyolysis, and respiratory failure. Therapeutic management remains supportive – intravenous fluids, atropine, and mechanical ventilation as needed. Inadvertent exposures are typical, but liquid nicotine may also be used for intentional overdose in suicide attempts.
Another proud cultural innovation for the 21st century.
“Liquid Nicotine Toxicity”
http://www.ncbi.nlm.nih.gov/pubmed/26148101