Unintentional Pediatric Ingestion of Electronic Cigarette Nicotine Refill Liquid Necessitating Intubation

Ann Emerg Med. 2017 Jan;69(1):94-97. doi: 10.1016/j.annemergmed.2016.08.448. Epub 2016 Dec 14.


Liquid nicotine used in electronic cigarette devices is highly concentrated, unreliably packaged, and poorly regulated. We present a case report of a 6-year-old female who developed severe toxicity and required intubation after an unintentional oral ingestion of approximately 703 mg (35 mg/kg) of liquid nicotine, with accompanying serum and urine concentrations of nicotine and its metabolites. Analysis of the ingested liquid suggests a nicotine concentration of 140.6 mg/mL in the purchased commercial product, or 234% of its labeled concentration. Clinicians should be aware of these products and the potential severity of toxicity they may incur.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Drug Overdose / therapy*
  • Electronic Nicotine Delivery Systems / adverse effects*
  • Female
  • Humans
  • Intubation, Intratracheal
  • Nicotine / blood
  • Nicotine / poisoning*
  • Nicotine / urine


  • Nicotine