When a 6-year-old girl in Oregon sprained her ankle, her father reached for their liquid child ibuprofen bottle and gave his daughter a 10ml dose. She lost consciousness almost immediately and her limbs began to jerk, so he took a tiny sip and realized it was liquid nicotine for his wife's e-cigarette; she had used the empty container to mix her own e-liquid, reports Health Day. The father called poison control and 911, and the girl barely survived a harrowing night in the emergency room and intensive care unit, where she was treated for acute nicotine poisoning and placed on a ventilator, the doctors report in the journal Annals of Emergency Medicine.
The case study comes on the heels of the surgeon general calling e-cigarettes "a major public health concern," researchers write in a press release. "As electronic cigarette use proliferates, children are now increasingly at risk of toxicity from ingestions of much larger quantities of nicotine from highly concentrated refill liquid," one toxicologist says. The girl had ingested 700 milligrams of liquid nicotine, higher than the 500mg threshold that can kill an adult, and her blood nicotine level was 348 nanograms per milliliter, far higher than the 12 to 54 ng/ml found after an adult smokes one regular cigarette, reports Live Science. The doctor says that "slightly different circumstances" would have easily led to "a tragic outcome." (Many victims of e-liquid poisoning are younger than 4.)