Eucalyptus Oil Poisoning

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  • See also:

    Poisoning – acute guidelines for initial management
    Essential oil Poisoning
    Camphor Poisoning
    Hydrocarbons Poisoning

    Key points

    1. Eucalyptus oil is highly toxic. Small ingestions of pure oil (≥5 mL) can lead to severe symptoms
    2. Symptom onset is usually rapid (within 30 mins) but can be delayed up to 4 hours after exposure
    3. CNS depression and respiratory compromise are the main features of eucalyptus oil poisoning to monitor for

    For 24 hour advice, contact the Poisons Information Centre 13 11 26


    Eucalyptus oil is a popular household product, commonly presented as an essential oil, medicinal product, cleaning product, inhalational/vaporiser fluid or topical preparation

    Onset: Within 30 mins to 4 hours post ingestion
    Duration of symptoms: usually resolve within 24 hours

    Dose related toxicity
    Small ingestions of pure oil can lead to severe symptoms.  A dose of 2-3 mL can induce mild CNS depression with drowsiness and/or dizziness and ataxia. A dose of ≥5 mL can induce significant CNS depression with coma

    Children requiring assessment

    All patients with deliberate self-poisoning or significant accidental ingestion
    Any symptomatic patient
    Single dose ingestion of >5mL
    Children where developmental age is inconsistent with accidental poisoning, as non-accidental poisoning should be considered

    Risk assessment


    • Intentional overdose or accidental
    • Dose: Stated or likely dose taken
    • Route of exposure: eg inhalation, ingestion, intranasal, topical (consider frequent, repeated topical applications)
    • Preparation type: if possible determine the exact name and % solution (2-3 mL is significant in a child whilst >5 mL may be associated with severe toxicity).
    • Co-ingestants: eg paracetamol, other essential oils


    • CNS: Miosis or mydriasis (miosis more commonly), myoclonus, CNS depression (drowsiness and dizziness with small exposures, ataxia, seizures, coma with larger (≥5 mL) exposures)
    • CVS:  Tachycardia, hypotension
    • Respiratory: Depression, apnoea, bronchospasm, signs of aspiration pneumonitis
    • GIT: Nausea, vomiting and diarrhoea(early symptoms), epigastric pain
    • Skin: Irritation, contact dermatitis

    Always check for Medicalert bracelet in any unconscious patient, or any other signs of underlying medical condition (fingerprick marks etc)


    Asymptomatic children with small ingestions do not usually require investigation


    • Chest X-ray and blood gas if signs of aspiration pneumonitis
    • UEC and LFT in children with significant illness or large ingestions (≥5 mL)
    • Paracetamol level in all intentional overdoses

    Acute Management

    1. Resuscitation

    • Standard procedures and supportive care
    • Aspiration/chemical pneumonitis is managed supportively with oxygen and bronchodilators. May require non-invasive ventilation or intubation if severe.  Corticosteroids and prophylactic antibiotics are not indicated
    • Fever is common following aspiration with pneumonitis, therefore antibiotics should be withheld until there is objective evidence of bacterial infection

    2. Decontamination 
    Charcoal is contraindicated due to risk of aspiration

    Ongoing care and monitoring

    • Asymptomatic children with significant exposure and normal vital signs, including normal GCS, should be observed for 4 hours post exposure before discharge
    • Symptomatic patients should be admitted for a longer period of observation +/- supportive care
    • Enhanced elimination: ineffective
    • Antidote: Nil

    Consider consultation with local paediatric team when

    Mental health assessment and admission should be considered for all adolescent patients with an intentional overdose.

    Consult Victorian Poisons Information Centre 13 11 26 for advice

    Consider transfer when

    Significant CNS depression, seizures or respiratory compromise requiring management in a paediatric intensive care unit

    For emergency advice and paediatric or neonatal ICU transfers, see Retrieval Services.

    Consider discharge when

    Normal GCS
    No respiratory symptoms
    Period of observation as above

    Assessing risk and connecting to community services
    • Prior to discharge, adolescents who present with deliberate ingestions need a risk assessment regarding the likelihood of further ingestions or other attempts to self-harm
    • Assessment of other drug and alcohol use should be undertaken
    • If, after risk assessment, it is deemed safe to discharge the child or adolescent from hospital, but ongoing mental health or drug and alcohol needs are identified, they should be linked with appropriate services (see links below for services in the State of Victoria) 

    Discharge information and follow-up

    Parent Information: Poisoning prevention for children
    Prevention of poisoning (Victorian Poisons Information Centre)

    Poisons Information Centre: Phone 13 11 26


    Last Updated July 2021


    Reference List

    • TOXINZ Australia, DHHS. Eucalyptus Oil. (viewed 14 April 2021)
    • Austin Clinical Toxicology Service Guideline. Hydrocarbons and Essential Oils. (viewed 14 April 2021).
    • Therapeutic Guidelines: Essential Oil poisoning. (viewed 14 April 2021).
    • Lee, K et al. Essential oil exposures in Australia: analysis of cases reported to the NSW Poisons Information Centre. Medical of Journal Australia. 2020. 212(3), p132-133.