What Can Peppermint Oil Do When Ingested?

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A female went into a coma after ingesting an unknown quantity of peppermint oil. She required mechanical ventilation and rigorous treatment!

A 40-year-old female presented to the emergency room after her family suspected that she has ingested peppermint oil. At the presentation, there was a strong smell of mint emitting from her.  The exact amount ingested remained unknown.

On examination, the patient was in a coma with a heart rate of 60 per minute, respiratory rate of 8 per minute, oxygen saturation of 30%. However, her blood pressure was not recordable, her peripheral pulses were absent, and the extremities were cold and clammy.

Chest auscultation revealed normal vesicular breath sounds. Examination of the precordium was unremarkable.

The doctors immediately intubated the patient. Also, they performed gastric lavage with warm normal saline. Despite intravenous fluid infusion, her blood pressure did not improve. Therefore, the doctors started her on intra-venous dopamine. Simultaneously, they decontaminated her; changed all her clothes followed by wet sponging. A warming blanket and radiant warmer were applied.

The doctors inserted a central venous catheter through the right subclavian vein. Her urinary bladder was catheterized. Moreover, she received ranitidine intravenous, intravenous ceftriaxone, intravenous gentamycin, intravenous metoclopramide, and antacid through a nasogastric tube.

The doctors ruled out aspiration through imaging. Additionally, ECG showed sinus bradycardia.

The doctors considered a working diagnosis of peppermint oil-induced nephrotoxicity, therefore, they stopped gentamycin. Clinically, she improved over the next couple of hours.

Gradually her doctors tapered the dopamine infusion. Subsequently, they stopped the dopamine infusion 8 hours later.

With adequate management, fortunately, she started responding to physical stimuli and to her name at 8 hours and 24 hours, respectively. The doctors weaned her off from the ventilator after 24 hours.

After 36 hours, she was conscious stabilised. She was able to maintain 100% oxygen saturation on room air. Consequently, they discharged him from the ICU.

SOURCEIndian Journal of Anaesthesia
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Dr. Arsia Parekh
Dr. Arsia Hanif has been a meritorious Healthcare professional with a proven track record throughout her academic life securing first position in her MCAT examination and then, in 2017, she successfully completed her Bachelors of Medicine and Surgery from Dow University of Health Sciences. She has had the opportunity to apply her theoretical knowledge to the real-life scenarios, as a House Officer (HO) serving at Civil Hospital. Whilst working at the Civil Hospital, she discovered that nothing satisfies her more than helping other humans in need and since then has made a commitment to implement her expertise in the field of medicine to cure the sick and regain the state of health and well-being. Being a Doctor is exactly what you’d think it’s like. She is the colleague at work that everyone wants to know but nobody wants to be. If you want to get something done, you approach her – everyone knows that! She is currently studying with Medical Council of Canada and aspires to be a leading Neurologist someday. Alongside, she has taken up medical writing to exercise her skills of delivering comprehensible version of the otherwise difficult medical literature. Her breaks comprise either of swimming, volunteering services at a Medical Camp or spending time with family.

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