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Ethylene Glycol Poisoning, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Peak serum concentration in 1–4 hr

  • Half-life, 2.5–4.5 hr

  • <20% excreted unmetabolized by kidneys

  • Pathophysiology:

    • Metabolized by hepatic alcohol dehydrogenase and aldehyde dehydrogenas...

Diagnosis

Signs and Symptoms

  • Cardiovascular:

    • Tachycardia/bradycardia/other dysrhythmias

    • Hypertension/hypotension

  • CNS:

    • Inebriation/irritability

    • Ataxia

    • Obtundation

    • Coma

    • Cerebral edema

    • Convulsions

    • Peripheral nervou...

Treatment

Pre-Hospital

  • Bring containers of all possible substances ingested.

  • Monitor airway and CNS depression.

  • Dermal decontamination of an ethylene glycol chemical spill by removal of clothing and jewe...

Follow-Up

Disposition

Admission Criteria

  • All patients with significant ethylene glycol ingestion, even if initially asymptomatic

  • ICU admission for seriously ill patients, metabolic acidosis, and renal fa...

Pearls and Pitfalls

  • An osmol gap <10 mmol/L does not rule out an ethylene glycol exposure.

  • Administer fomepizole immediately and confirm exposure with a serum concentration for patients with an elev...

Additional Reading

  • Leikin  J, Paloucek  F. Ethylene glycol. Fomepizole. Alcohol. In: Leikin  JB, Paloucek  F, eds. Leikin and Paloucek's Poisoning and Toxicology Handbook. 4th ed. Boca Raton, FL: Le...

Codes

ICD9

982.8 Toxic effect of other nonpetroleum-based solvents 

ICD10

  • T52.8X1A Toxic effect of organic solvents, accidental, init

  • T52.8X2A Toxic effect of organic solvents, self-harm, init

  • T52.8X4A Tox...

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