Treatment of hydrocarbon pneumonitis consists of airway control if there is mental status depression and mechanical ventilation if ventilation is impaired Acute respiratory distress syndrome may ensue, and heroic measures such as extracorporeal membrane oxygenation have been successfully employed Antibiotics should not be used prophylactically but should be reserved for specific infections if they develop The use of corticosteroids is associated with increased morbidity and is not recommended In the event of hypotension or bronchospasm, epinephrine should be avoided if possible because hydrocarbons are known to cause ventricular irritability and predispose to fibrillation, an effect that is exacerbated by catecholamines Lead CLINICAL PEARLS No safe blood lead level in children has been identified The most important aspect of lead poisoning treatment is removal from further lead exposure Lead encephalopathy is now rare in the United States, but clinicians must maintain a high index of suspicion in children with lead exposure and GI and neurologic symptoms Patients with lead encephalopathy should be treated with dimercaprol (BAL) IM followed by IV calcium disodium EDTA, in addition to aggressive supportive care Current Evidence Although lead poisoning is usually the result of residential lead paint in children or of occupational exposure in adults, patients with lead poisoning may come to the ED with varied complaints of recent onset that often mimic diverse acute illnesses Fortunately, severe lead encephalopathy is now rare, attributable in large part to widespread screening programs and early recognition of asymptomatic or mildly ill children The major source of excess lead absorption in children is lead-based paint, widely used in home interiors through the 1950s In addition to the ingestion of macroscopic-sized chips of paint, children are often exposed to house dust with a high lead content that results from finely crumbled paint particles, which gets on their hands and toys Repetitive mouthing can lead to increased lead exposure even in the absence of observable pica Home renovation often includes sanding, stripping, and burning of lead-based paint from woodwork in houses and is been