We suggest you to look for vaping in any patient with ALI-ARDS: From scattered case reports since 2014 to a full epidemic in 2019. See under 'e-cigarette'. Epidemic's figures declining as of Jan, 2020

ILD, ARDS, sudden asthma attacks, acute eosinophilic pneumonia, DAH increasingly recognized as possible acute sometimes life-threatening complications in ENDS users. Added THC may be causaitive in a fraction of the patients. ECMO required in some. Please include ENDS use in ANY Hx taking. Particular attention required on substances possibly added to e-liquid including but not limited to marijuana, hash oil, butane H oil, resin, cocaine, Meth, cannabinoids, cathinones, incense, and/or other drugs/substances. Some of these may also case severe brain dysfunction and/or behavioral changes. Test blood/urine for natural/synthetic substances in any suspicious case as early as possible upon admission. We at Pneumotox keep literature including forensic literature updated daily (copy on request)