First Aid for 4-Methylcyclohexane Methanol Poisoning

First Aid for 4-Methylcyclohexane Methanol Poisoning

Article
Ear, Nose, & Throat (ENT)
Eye & Vision
+4
Contributed byKrish Tangella MD, MBANov 02, 2021

What is 4-Methylcyclohexane Methanol Poisoning?

  • 4-methylcyclohexane methanol (or 4-MCHM) is a chemical that is used in certain industries for purification of coal for metallurgical operations and blending gasoline. According to recent reports, the chemical is also patented for use in air fresheners
  • 4-MCHM is a colorless liquid, which has a sweet smell, like licorice. It is highly soluble in organic solvents but slightly soluble in water due to its oily consistency
  • The other names for 4-MCHM are:
    • 1-(hydroxymethyl)-4-methylcyclohexane
    • 4-methylcyclohexyl-1-carbinol
  • Ingestion or exposure to 4-MCHM can lead to 4-Methylcyclohexane Methanol Poisoning. This may be accidental or intentional
  • The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

4-Methylcyclohexane Methanol Poisoning may be variously referred to as:

  • 4-MCHM Poisoning
  • 4-MCHM Toxicity
  • 4-Methylcyclohexane Methanol Toxicity
  • 4-Methylcyclohexylmethanol Poisoning
  • 4-Methylcyclohexylmethanol Toxicity

What are the Causes of 4-Methylcyclohexane Methanol Poisoning?

  • Exposure to 4-methylcyclohexane methanol usually takes place through contaminated water that affects one’s skin and/or eyes. The compound may be ingested or inhaled
  • 4-Methylcyclohexane Methanol Poisoning could be accidental, or in some cases intentional, to bring self-harm

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of 4-Methylcyclohexane Methanol Poisoning?

The signs and symptoms of 4-Methylcyclohexane Methanol Poisoning can vary from one individual to another. It may be mild in some and severe in others. The signs and symptoms may include:

  • Eye irritation
  • Nausea and vomiting
  • Diarrhea
  • Headache, dizziness
  • Skin irritation, redness with itching
  • Respiratory tract irritation causing burning sensation
  • Breathing difficulty

Vapors released at elevated temperatures can cause eye irritation and respiratory tract irritation.

How is First Aid administered for 4-Methylcyclohexane Methanol Poisoning?

First Aid for 4-Methylcyclohexane Methanol Poisoning:

  • Call 911 or your local emergency help number for emergency assistance
  • Call the poison control center at 1-800-222-1222 (or your local poison control center) for further instructions
  • Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
  • Carefully remove the individual from the exposure area; move them to region of fresh air immediately
  • Confirm that the airways are protected; also, ensure breathing and the presence of pulse
  • If the individual is unconscious, place them sideways (on their side) to avoid choking. Start artificial respiration (CPR), if not breathing
  • Determine the mode, time of exposure, patient’s age, weight and general health status
  • If exposure of the skin has occurred, then wash thoroughly with mild soap and copious amounts of water (for 15 minutes)
  • Eye irritation: Flush eyes with clean water for 15 minutes.  If possible, remove contact lenses
  • Remove clothes and shoes exposed to 4-MCHM. Destroy or thoroughly clean exposed clothes and shoes
  • If the individual has consumed contaminated water containing the chemical, then rinse mouth with water (if the individual is conscious)
  • Do not give anything by way of mouth, particularly if the individual is unconscious
  • Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
  • Take individual to emergency room (ER) for further treatment

The emergency medical health professional might perform the following steps towards treating the condition:

  • Monitor vital signs
  • Medical treatment is usually symptom management and might include relieving respiratory distress with nebulizer breathing treatments and/or artificial respirator if indicated
  • Administer fluids by an intravenous drip line
  • Medical management of nausea and diarrhea
  • Administration of activated charcoal to avoid systemic absorption of the chemical into the body

Who should administer First Aid for 4-Methylcyclohexane Methanol Poisoning?

First aid for 4-Methylcyclohexane Methanol Poisoning is administered by healthcare professionals.

  • The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
  • The person exposed to 4-MCHM should try to limit further exposure and begin first aid before treatment at a medical facility is sought
  • They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of 4-Methylcyclohexane Methanol Poisoning?

  • The prognosis of 4-Methylcyclohexane Methanol Poisoning is dependent on the extent of exposure, severity of symptoms displayed, and time from exposure to treatment
  • Individuals with severe exposure and symptoms may have a poorer prognosis than those with milder exposures presenting less severe symptoms

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can 4-Methylcyclohexane Methanol Poisoning be Prevented?

4-Methylcyclohexane Methanol Poisoning may be prevented by considering the following steps:

  • Do not drink water that is exposed to 4-methylcyclohexane methanol
  • Do not shower, brush teeth, or cook with water exposed to 4-MCHM
  • Boiling contaminated water does not eliminate 4-MCHM effectively; use bottled water if your water supply is exposed to the chemical compound
  • Keep all poisons correctly labeled and in suitable storage locations
  • Wear appropriate protective wear, including eye safety glasses, when working with such chemicals
  • Ensure that adequate ventilation is provided at work places where such chemicals are handled
  • Avoid contact of the chemical with skin and eyes
  • Dispose chemical substances and their containers, including contaminated packaging material, per appropriate governing industry practices and regulations
  • Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

What are certain Crucial Steps to be followed?

  • Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
  • Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
  • It would be helpful if the following information is readily available:
    • Type, amount and time of consumption of the substance
    • Age and weight of the individual
    • And, the overall health status of the individual
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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