Acute nicotine poisoning in a 2-year-old child – A case report of a near-death event

Acute nicotine poisoning is a devastating condition that occurs when there is an excessive intake of nicotine, a toxic alkaloid found in tobacco products, mainly e-cigarettes. It impairs respiratory and neurological functioning due to its massive inflammatory effect. It is mainly related to vaping activity. Most smokers know about smoking's adverse effects and implications. However, public awareness is still poor, and a majority are unable to quit the trending vaping addiction. Nevertheless, the potential severity of its toxicity to a growing child both in the short and long term is of critical concern, especially in cases of accidental direct ingestion. We report the case of a 2-year-old child who presented with acute respiratory failure secondary to liquid nicotine ingestion at home. The child was first seen by the medical team at primary care and required urgent intubation and paediatric intensive care unit admission. Her condition was complicated with several episodes of seizure requiring close monitoring. This case highlights that despite ignorance of adults on the danger of vaping, significant harm can still occur among children at home when parents engage in vaping. Although adults may take certain precautions, their harmful habits can indirectly and directly affect children, making the risk unavoidable. This serves as an urgent call for the government to strictly ban nicotine products and enact corresponding legislation immediately.