What IV fluid is recommended for treating camphor poisoning?

IV Fluid Management in Camphor Poisoning

Primary Recommendation

There is no specific IV fluid recommendation for camphor poisoning in the available evidence; treatment is primarily supportive with IV fluids used for hydration and as a vehicle for medication administration, with normal saline (0.9% sodium chloride) or dextrose-containing solutions being reasonable choices based on general poisoning management principles.

Clinical Context and Management Approach

Camphor poisoning requires rapid assessment and supportive care, as toxicity manifests within minutes and can progress to life-threatening complications 1, 2, 3.

Key Clinical Features Requiring IV Access

• Seizures are the most prominent manifestation, occurring as early as 5 minutes after exposure and requiring immediate benzodiazepine administration 1, 2
• Neurologic symptoms including confusion, agitation, restlessness, delirium, lethargy, and ataxia may develop 1, 2, 3
• Cardiovascular effects including cardiac arrhythmias and potential QRS widening on ECG require monitoring 2
• Gastrointestinal symptoms such as severe nausea and vomiting can lead to dehydration 1

IV Fluid Selection Strategy

For camphor poisoning specifically:

• Standard isotonic crystalloids (normal saline or lactated Ringer's) should be used for volume resuscitation and maintaining adequate hydration 2
• Dextrose-containing solutions (such as D5 normal saline) may be considered if hypoglycemia is present or anticipated, though this is not a specific feature of camphor toxicity 4
• IV access is essential primarily as a route for benzodiazepine administration to control seizures, which is the cornerstone of symptomatic management 1, 2

Specific Management Priorities

Seizure control takes precedence:

• Benzodiazepines should be administered intravenously to control convulsions 1
• IV fluids serve as the vehicle for medication delivery and maintain hydration during the acute phase 2

Monitoring requirements:

• ECG monitoring for QRS complex widening and cardiac arrhythmias is essential 2
• Mental status should be closely observed, as toxic effects may persist beyond the typical 24-48 hour window, with some cases showing symptoms for up to 19 days 3

Important Clinical Pitfalls

• Do not delay treatment for gastrointestinal decontamination—ipecac should NOT be used, and activated charcoal is NOT recommended for camphor ingestion alone 1
• Do not underestimate small doses—as little as 500 mg can cause mortality in children, and 750-1000 mg is associated with seizures and death 5
• Anticipate rapid progression—patients who ingest more than 30 mg/kg or show any symptoms of moderate to severe toxicity require immediate emergency department referral 1
• Expect potential prolonged effects—while most sources indicate resolution within 24-48 hours, persistent delirium and neurologic symptoms may continue for weeks in some cases 3

Observation and Disposition

• Asymptomatic patients who remain symptom-free for 4 hours after exposure can be safely observed at home 1
• Symptomatic patients require hospital admission with supportive care, IV access for medication administration, and continuous monitoring 1, 2