Evali (E-Cigarette or Vaping-Associated Lung Injury)
Medically reviewed by Drugs.com. Last updated on Mar 5, 2023.
E-cigarette or vaping-associated lung injury (EVALI) is life-threatening lung damage from vaping. Effects can start days to weeks after you use a vaping product.
Call your local emergency number (911 in the US) if:
- You have severe breathing problems.
- You have chest pain.
Return to the emergency department if:
- Your symptoms get worse.
- You cough up blood.
- Your heart beats more than 100 beats in 1 minute.
- You are very tired, confused, and cannot think clearly.
- Your lips or fingernails turn gray or blue.
Call your doctor if:
- You have a fever higher than 101°F (38.3°C).
- You cannot eat, or you have loss of appetite, nausea, or are vomiting.
- You have questions or concerns about your condition or care.
You may need any of the following:
- Steroids may be given to reduce inflammation in your lungs.
- Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
- Antiviral medicine may be given to help fight a viral infection.
- Antibiotics help prevent or fight a bacterial infection.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Manage your symptoms:
- Rest as needed. Rest often while you recover. Slowly start to do more each day.
- Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. Liquids help thin your mucus, which may make it easier for you to cough it up.
- Use a cool mist humidifier to increase air moisture in your home. This may make it easier for you to breathe and help decrease your cough.
- Keep your head elevated. You may be able to breathe better if you lie with the head of your bed up. You can also prop your head and upper body up with pillows. Talk to your child's healthcare provider about how to do this safely. Do not prop a young child up with pillows. He or she can become trapped under a pillow and not be able to breathe.
Prevent or manage EVALI:
- Stop using vaping products until the cause is known. Authorities recommend that you at least do not use products that contain THC. But it is not known for sure which vaping products cause EVALI. It is safest to stop using all vaping products until the cause is known. Ask your healthcare provider for information if you want to quit but need help. Do not start or go back to smoking cigarettes in place of vaping.
- Do not buy any vaping products from outside sources. If you plan to continue vaping, only buy from licensed sources. This is especially important if you want to vape products that contain THC. Do not use vaping products given to you by friends or family members.
- Never add vitamin E acetate to thicken a product. This is especially important for products that contain THC. You may want to stop adding anything to your vaping products until the cause of EVALI is known.
- Call your healthcare provider right away if you have symptoms of EVALI. Even if your symptoms are mild, let your provider know. Symptoms can get worse quickly.
- Ask about vaccines you may need. Influenza (the flu), COVID-19, and pneumonia can become life-threatening for a person who has EVALI. Get a flu vaccine as soon as recommended each year, usually starting in September or October. Get a COVID-19 vaccine and recommended booster doses. The pneumonia vaccine may be given every 5 years, or as directed. Ask about other vaccines you may need and when to get them.
For support and more information:
- US Food and Drug Administration
10903 New Hampshire Avenue
Silver Spring , MD 20993
Phone: 1- 888 - 463-6332
Web Address: http://www.fda.gov
Phone: 1- 800 - 784-8669
Web Address: www.smokefree.gov
Follow up with your doctor in 24 to 48 hours:
Symptoms of EVALI can be mild at first but become severe. Your doctor will check your oxygen level. You may also need a chest x-ray to check your lungs. Your doctor may refer you to a lung specialist. Write down your questions so you remember to ask them during your visits.
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