General safety guidelines

General safety guidelines

CHAPTER CONTENTS

First aid

If you or someone you are with is suffering a serious adverse event, seek immediate help from your local poison center or hospital.

Most adverse reactions to essential oils are without any serious consequence, but if young children ingest any amount, medical attention should be sought urgently. After suspected ingestion of an essential oil, asymptomatic children are normally observed for six hours, and drinking of water is encouraged. Symptomatic children require hospital admission (Riordan et al 2002). Activated charcoal is regarded as ineffective for treating essential oil poisoning (Jepsen & Ryan 2005). A summary of first aid procedures for essential oil toxicity is given in Box 15.1.

Box 15.1

General first aid procedures in cases of adverse reactions following exposure to essential oils by different routes

• Do not induce vomiting (corrosive chemicals may destroy mucous membranes, and there is a risk of aspiration into the victim’s lungs during vomiting)

• If the person is conscious and not convulsing, rinse mouth with water and immediately call a hospital or poison center. Avoid alcohol

• If the person is convulsing or unconscious do not give anything by mouth. Ensure their airway is open and lay them on their side with the head lower than the body

• Transport the person to a hospital as soon as possible

• Remove person to fresh air

• If not breathing, give artificial respiration, preferably mouth-to-mouth

• Seek medical attention

• Flush eye(s) with water for at least 15 minutes. If there are contact lenses, remove them after the first 5 minutes, then continue rinsing eye(s)

• Ensure adequate flushing of the eyes by separating the eyelids with fingers

• Seek medical advice if irritation persists

• Remove any contaminated clothing.

• Wash the skin gently with (preferably unperfumed) soap and water for at least 10 minutes

• Expose the skin to the air (but not to direct sunlight) to encourage evaporation of remaining essential oil.

• Lukewarm oatmeal baths may help soothe reactions spread over large areas of skin.

• Application of a simple barrier cream, or a mild corticosteroid cream is the normal medical approach (although ACD to topical corticosteroids is possible).

• Oral antihistamines may help reduce itching (topical antihistamines should be avoided because of the risk of ACD).

• Seek medical attention if irritation persists.

(Partly adapted from safety data sheets for essential oils.)

Signs and symptoms of toxicity

Topical exposure to some essential oils may cause local skin reactions including irritation, allergic reaction, and photosensitization, especially if undiluted oils are used. If essential oils get into the eyes, reddening and lacrimation are likely to occur, and a child may rub their eyes. If essential oils have been instilled nasally, signs and symptoms of airway irritation are likely, ranging from nasal irritation through various degrees of respiratory edema and distress to respiratory arrest. If sufficient amounts are absorbed by this route, systemic poisoning may result, as for oral ingestion.

The advice given to doctors dealing with essential oil poisoning following oral ingestion is that the initial effects generally include mucosal irritation, epigastric pain, vomiting and diarrhea, and that convulsions, CNS depression and hepatic and renal failure may follow (Riordan et al 2002). Table 15.1 gives a summary of common signs and symptoms of poisoning by essential oils. Many published cases of poisoning are detailed in the appropriate essential oil profile in Chapter 13.

Table 15.1

Poisoning from specific essential oils after acute oral ingestion

Essential oil	Signs and symptoms
Camphor	Initially CNS stimulation (delirium, convulsions), followed by depression (ataxia, coma) Possibly nausea, vomiting, vertigo, confusion, respiratory failure
Cinnamon bark	A burning sensation in the mouth, chest and stomach, dizziness, double vision, nausea, vomiting, collapse
Citronella	Vomiting, shock, frothing at the mouth, fever, deep and rapid respiration, cyanosis, convulsions
Clove	Acidosis, deteriorating liver function, CNS depression, deep coma, convulsions, ketonuria, low blood glucose
Eucalyptus	CNS depression (drowsiness, coma), abnormal respiration (shallow or labored breathing), pinpoint pupils, ataxia, vertigo, epigastric pain, vomiting, weakness in the legs, cold sweats, headache
Hyssop	Convulsions
Parsley/apiole	Fever, severe abdominal pain, vaginal bleeding, vomiting, diarrhea
Pennyroyal	Fever, delirium, nausea, vomiting, dizziness, coma, tingling and numbness of the extremities, hemorrhage
Pine	Drowsiness, delirium, headache, nausea, ataxia, tachycardia, paresis, gastroenteritis, toxic nephritis, renal failure
Sage (Dalmatian)	Convulsions
Thuja	Convulsions, gastroenteritis, flatulence, hypotension
Sassafras	Principally shock, vomiting. CNS depression causing inadequacy of respiration and blood circulation. Similar clinical picture to that of eucalyptus, except for pinpoint pupils
Tea tree	Convulsions, ataxia, drowsiness
Wintergreen/methyl salicylate	Convulsions, vomiting, fever, rapid and labored breathing, cyanosis, tachycardia, respiratory alkalosis, tinnitus, deafness
Wormseed	Generalized edema, skin and mucous membrane irritation, headache, vertigo, tinnitus, double vision, nausea, vomiting, constipation, deafness, blindness

Reporting adverse events

In the US, consumers and health professionals can report adverse events from essential oils electronically by visiting the FDA’s Medwatch site at https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm (accessed August 28th 2012).

In Canada, essential oil reactions can be reported to Health Canada, by visiting http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/reaction-eng.php#Consumer (accessed August 28th 2012).

In the UK, the equivalent body is the MHRA, and their website can be accessed at http://www.mhra.gov.uk/index.htm (accessed August 28th 2012). However, there is no provision for reporting reactions to essential oils.

In Australia, adverse events can be reported to the Therapeutic Goods Administration http://www.tga.gov.au (accessed August 28th 2012).

Safety in healthcare

The following are guidelines for preventing or managing adverse reactions.

Adverse skin reactions

• do not apply undiluted essential oils to any part of the body

• before applying to the skin, essential oils should be appropriately diluted, depending on the oils used

• adding undiluted essential oils to bathwater is inadvisable

• individuals with a personal or family history of atopic dermatitis, with a history of skin contact allergy or perfume allergy, or with a current skin condition, may be at greater risk of adverse skin reactions.

Only gold members can continue reading. Log In or Register to continue

Related

Stay updated, free articles. Join our Telegram channel

Tags: Essential Oil Safety A Guide for Health Care Professionals

Jun 14, 2017 | Posted by admin in GENERAL SURGERY | Comments Off

Full access? Get Clinical Tree

Get Clinical Tree app for offline access

Get Clinical Tree app for offline access