Refrigerant poisoning

Coolant poisoning; Freon poisoning; Fluorinated hydrocarbon poisoning; Sudden sniffing death syndrome

Definition

A refrigerant is a chemical that makes things cold. This article discusses poisoning from sniffing or swallowing such chemicals.

The most common poisoning occurs when people intentionally sniff a type of refrigerant called Freon.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

The poisonous ingredient includes fluorinated hydrocarbons.

Where Found

The poisonous ingredients may be found in:

  • Various refrigerants
  • Some fumigants

This list may not be all-inclusive.

Symptoms

LUNGS

EYES, EARS, NOSE, AND THROAT

  • Severe pain in the throat
  • Severe pain or burning in the nose, eyes, ears, lips, or tongue
  • Loss of vision

STOMACH AND INTESTINES

  • Severe abdominal pain
  • Vomiting
  • Burns of the food pipe (esophagus)
  • Vomiting blood
  • Blood in the stool

HEART AND BLOOD

  • Irregular heart rhythms
  • Collapse

SKIN

  • Irritation
  • Burn
  • Necrosis (holes) in the skin or underlying tissues

Most symptoms result from breathing in the substance.

Home Care

Seek emergency medical care right away. Move the person to fresh air. Be careful to avoid being overcome by the fumes while helping someone else.

Contact poison control for further information.

Before Calling Emergency

Determine the following information:

  • The person's age, weight, and condition
  • The name of the product (ingredients and strength, if known)
  • The time it was swallowed or inhaled
  • The amount swallowed or inhaled

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

What to Expect at the Emergency Room

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The person may receive:

  • Intravenous (IV) fluids through the vein
  • Medicines to treat symptoms
  • Tube through the mouth into the stomach to wash out the stomach (gastric lavage)
  • Endoscopy - camera placed down the throat to see burns in the esophagus and the stomach
  • Medicine (antidote) to reverse the effect of the poison
  • Washing of the skin (irrigation), perhaps every few hours for several days
  • Skin debridement (surgical removal of burned skin)
  • Breathing tube
  • Oxygen

Outlook (Prognosis)

How well a person does depends on the severity of the poisoning and how quickly medical help was received.

Severe lung damage may occur. Survival past 72 hours usually means the person will have a complete recovery.

Sniffing Freon is extremely dangerous and can lead to long-term brain damage and sudden death.

References

Theobald JL, Kostic MA. Poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 77.

Wang GS, Buchanan JA. Hydrocarbons. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 147.

Schedule An Appointment

Review Date: 7/1/2023

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.


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