Treatment of Camphor Poisoning
Contact poison control immediately and provide aggressive supportive care, as there is no antidote available for camphor poisoning. 1
Immediate Emergency Response
- Call poison control or emergency services immediately while initiating treatment, as board-certified toxicologists can provide specialized guidance for camphor exposures 1
- Transport patients exhibiting seizures to an emergency department via pre-hospital emergency medical services 2
- Refer patients with suspected self-harm or malicious administration to an emergency department immediately, regardless of amount ingested 2
Triage and Referral Criteria
- Refer to emergency department if ingestion exceeds 30 mg/kg or if moderate to severe symptoms are present (seizures, lethargy, ataxia, severe nausea/vomiting) 2
- Observe asymptomatic patients at home for 4 hours; if they remain symptom-free after this period, continued home observation is safe 2
- Recognize that seizures typically occur within 5-15 minutes of ingestion, though toxic effects may persist beyond the typical 24-48 hour window in some cases 3, 4
Supportive Care Management
- Provide aggressive supportive care including airway management, respiratory support, and hemodynamic stabilization, as this is the only available treatment option 1
- Administer 100% oxygen to maintain tissue oxygenation 1
- Control seizures with benzodiazepines as first-line therapy 2
- Monitor for severe complications including respiratory depression, metabolic acidosis, renal insufficiency, elevated hepatic enzymes, and aspiration pneumonitis 5
- Provide mechanical ventilation for patients with severe respiratory distress, hypoxemia unresponsive to supplemental oxygen, or severe CNS involvement requiring PICU transfer 4
Decontamination Strategies
What NOT to Do
- Do not induce emesis with ipecac syrup 2
- Do not perform gastric lavage 4
- Do not administer activated charcoal unless co-ingestion of other substances that are effectively adsorbed by charcoal has occurred 2
Route-Specific Decontamination
- For topical skin exposures: Wash thoroughly with soap and water, remove all contaminated clothing, and observe at home for symptom development 2
- For ocular exposures: Irrigate eyes copiously with tepid water for at least 15 minutes 1
- For inhalation exposures: Move patient to fresh air environment and refer based on symptom presence and severity; symptoms are unlikely to progress once removed from exposure 2
Critical Pitfalls to Avoid
- Do not delay emergency department referral based on initial lack of symptoms, as camphor has rapid onset of action (5-15 minutes) and can cause seizures even with small doses 4
- Do not assume resolution after 24-48 hours, as persistent delirium, headache, and memory loss can occur for up to 19 days post-ingestion 3
- Avoid using prophylactic antibiotics or corticosteroids, as there is no clear benefit 4
- Do not attempt gastrointestinal decontamination due to aspiration risk and lack of efficacy 2, 4