COMPLICATIONS FOLLOWING BUTANE INHALATION AND FLASH FIRE

Solvent inhalation is a well-documented form of drug abuse that can ca use euphoria and hallucinations. Sudden death involving a volatile sub stance is most commonly caused by cardiac arrythmias, asphyxia, direct drug effects, and trauma. The victim in this paper suffered superfici al partial thickness (12% total body surface area) burns from a flash fire that occurred when lighting a match after inhaling butane in an e nclosed vehicle. The victim was admitted to the hospital for 2 days of observation but did not develop any respiratory symptoms until 2 days following her release. The victim died during her readmission, 9 days after the flash fire. Postmortem examination showed extensive epithel ial injury from the upper airway and trachea to the terminal bronchiol es, most likely due in part to both the initial inhalation injury and the resulting adult respiratory distress syndrome (ARDS) and staphyloc occal infection. Many victims with superficial burn injuries may not s eek medical attention owing to either embarrassment or fear of legal p rosecution. Even those who do seek medical assistance may not reveal s olvent abuse as the cause of their injuries. It is possible that delay ed death may occur at home following volatile substance abuse but may remain unrecognized even with a thorough scene investigation.