Vape juice, also known as e-liquid, is the solution heated by electronic cigarettes to create an inhalable aerosol. It consists primarily of a base mixture—usually propylene glycol (PG) and vegetable glycerin (VG)—along with food-grade flavorings and nicotine. Ingestion poses a significant health risk because the nicotine is present in a highly concentrated liquid form. This concentration means that swallowing even a small amount can rapidly deliver a toxic dose to the bloodstream.
Immediate Protocol Following Ingestion
The moment vape juice is ingested, the situation must be treated as a medical emergency due to the rapid absorption of liquid nicotine. Contact the National Poison Control Center immediately at 1-800-222-1222 for expert guidance and assessment. Professional medical advice is necessary to determine the severity of the exposure and the appropriate course of action.
Do not attempt to induce vomiting unless specifically instructed by a medical professional or Poison Control. If the person is unconscious, having a seizure, or experiencing severe difficulty breathing, call 911 immediately. If the individual is conscious, rinse the mouth thoroughly with water to remove any residual liquid.
If the liquid has spilled onto the skin or splashed into the eyes, wash the affected skin area with soap and water for at least 15 minutes, or flush the eyes with lukewarm water for the same duration. Nicotine is readily absorbed through the skin, which can lead to systemic poisoning.
Key Components and Their Toxicity
The toxicity of vape juice stems almost entirely from its nicotine content, which acts as a neurotoxin when ingested. Nicotine first stimulates and then rapidly depresses the nervous system, affecting communication between nerve cells. While the historical lethal dose for adults was cited as 30 to 60 milligrams, modern research suggests the true fatal oral dose is significantly higher, potentially closer to 500 milligrams.
The degree of danger is directly related to the nicotine concentration, which is measured in milligrams per milliliter (mg/mL) on the product label. High-strength e-liquids, such as those containing 50 mg/mL, present a severe risk, as a few milliliters can contain a toxic dose. For small children, ingesting just one teaspoon of concentrated liquid nicotine can be fatal.
The non-nicotine base carriers, propylene glycol (PG) and vegetable glycerin (VG), are generally recognized as safe for consumption. These compounds are used to produce the visible aerosol cloud. Ingesting large volumes of PG or VG primarily causes mild gastrointestinal distress, such as nausea or diarrhea. Flavoring chemicals are secondary to nicotine in terms of acute toxicity risk upon ingestion.
Physical Symptoms of Nicotine Poisoning
Nicotine poisoning symptoms typically follow a biphasic pattern, beginning with an initial phase of stimulation, followed by a depressive phase. The onset of symptoms is often rapid, usually occurring within 15 minutes to one hour after ingestion.
Early symptoms include nausea, vomiting, excessive salivation, and abdominal pain, which is the body’s first defense against further absorption. The cardiovascular system reacts with tachycardia (rapid heart rate) and hypertension (elevated blood pressure). Neurological effects can involve dizziness, headache, tremors, and agitation.
As the body absorbs a larger dose, the secondary depressive phase begins, typically within 30 minutes to four hours. The heart rate slows dramatically (bradycardia), and blood pressure drops significantly (hypotension). Muscle weakness progresses to paralysis, including the muscles necessary for breathing. The most severe outcomes involve respiratory failure, seizures, coma, or cardiac arrest.
Factors Influencing Severity
The severity of a vape juice ingestion incident is determined by three interacting variables: concentration, volume, and body mass. The nicotine concentration, listed as mg/mL on the bottle, is the most important factor in calculating the potential dose. A small sip of a high-concentration liquid is far more dangerous than a larger volume of a low-concentration liquid.
The total quantity of liquid swallowed determines the absolute amount of nicotine delivered to the body. Medical risk is assessed based on the calculated total dose in milligrams, relative to the person’s body weight, expressed as milligrams per kilogram (mg/kg).
Body weight is a significant factor in vulnerability, which is why small children face greater danger. Children have a far lower body mass, meaning a small quantity of nicotine constitutes a much higher dose per kilogram of weight. This lower tolerance explains why accidental ingestion in a child can quickly result in life-threatening symptoms.