Ethylene Glycol, Methanol, Propylene Glycol, and Isopropyl Alcohol Ingestion

First Things First (assess & treat for the following)

• Diagnosis & early treatment require a high index of suspicion with the proper setting even w/o supporting lab data.
  • Obtundation & increased anion or osmolal gap: think of the toxic alcohol ingestions.
• Highest priority is maintenance of the ABCs.
• Then detoxification/elimination:
  • Charcoal is not helpful.
  • Lavage only if within 1 hour of recent large-volume ingestion
• Then correct metabolic abnormalities
  • Goal is to prevent development of toxic metabolites
  • OG = (2 x Na) + BUN/2.8 + Glucose/18 + EtOH/4.6
    • Normal OG is 12 +/- 2
  • AG = Na - Cl + HCO3
    • Normal AG is 12 +/- 4