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Methanol Poisoning, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Colorless, volatile liquid

  • Absorbed in 30–60 min

  • Metabolized by liver

  • Half-life 4–8 hr

  • Mechanism:

    • Inebriating

    • Nontoxic

    • Metabolites of formaldehyde and formic acid produce toxic effects.

    • Inhi...

Diagnosis

Signs and Symptoms

  • GI:

    • Anorexia

    • Nausea/vomiting

    • Abdominal pain

  • CNS:

    • Headache

    • Dizziness

    • Confusion

    • Inebriation

    • Coma

    • Seizures

  • Ophthalmologic:

    • Blurry/hazy vision

    • Photophobia

    • “Snowfield vision”

    • Blindness

    • Central ...

Treatment

Pre-Hospital

  • Transport all possibly ingested substances.

  • Dermal decontamination of a methanol spill by clothing removal, irrigation with soap and water

  • Monitor airway and CNS depression.

Initial Stabilization/Therapy

Follow-Up

Disposition

Admission Criteria

  • Significant historical methanol ingestion even if initially asymptomatic

  • ICU admission for seriously ill patients

  • Transfer to another facility if hemodialysis or a...

Pearls and Pitfalls

  • An osmol gap <10 mmol/L does not rule out a methanol exposure.

  • If you have a patient with an elevated anion gap and methanol exposure is in the differential diagnosis, administer...

Additional Reading

  • Desai  T, Sudhalkar  A, Vyas  U, et al. Methanol poisoning predictors of visual outcomes. JAMA Ophthalmol.  2013;131(3):358–364.

  • Leikin  J, Paloucek  F. Fomepizole. Leikin and P...

Codes

ICD9

980.1 Toxic effect of methyl alcohol 

ICD10

  • T51.1X1A Toxic effect of methanol, accidental (unintentional), initial encounter

  • T51.1X2A Toxic effect of methanol, intentional self-harm, initial en...

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