Snapshot A 35-year-old painter presents to the emergency room for nausea, vomiting, and a headache. He reports that a large vat of paint thinner had spilled, and he had spent the afternoon cleaning it up. While at the time he felt fine, an hour after he finished, he started experiencing these symptoms. On physical exam, he is oriented to self and place but not the year. He is tachycardic with a pulse of 112/min. Pulse oximetry reveals an oxygen saturation of 96% on room air. A CO-oximetry shows carboxyhemoglobin levels of 23%. He is started on 100% oxygen. A lactic acid level is drawn to assess for concomitant cyanide poisoning. Introduction Clinical definition login to view 1 more bullet ETIOLOGY Pathogenesis login to view 6 more bullets Associated conditions login to view 1 more bullet Epidemiology Incidence login to view 2 more bullets Risk factors login to view 9 more bullets Presentation Symptoms login to view 4 more bullets Physical exam login to view 7 more bullets Studies Diagnostic testing login to view 14 more bullets Differential Cyanide poisoning login to view 3 more bullets DIAGNOSIS Making the diagnosis login to view 2 more bullets Treatment Management approach login to view 2 more bullets First-line login to view 4 more bullets Second-line login to view 8 more bullets Complications Myocarditis Acute respiratory distress syndrome Prognosis Worse with very young or very old age Worse with prolonged or intentional exposures