Deep Dive MW R18

Phase One: CNS














* Ataxia, Slurred Speech, Confusion, N/V, Seizures














Phase Two: Cardiopulmonary














* CHF, Cardiogenic Shock/Hypotension, Pulmonary Edema, ARDS














Phase Three: Renal














* Flank pain, Hematuria, Oliguria, Renal Failure














Diagnosis:














* HIGH INDEX OF SUSPICION











* Ethylene Glycol Serum Level











* Elevated Osmolar Gap











* Serial Anion Gap Measurements














Treatment:














* Fomepizole or Ethanol to prevent breakdown to toxic glycolic acid/oxalic acid











* Hemodialysis











* Consider Bicarb drip, pyridoxine, and thiamine


























Further Reading:











EMCrit Toxic Alcohols