Toxic alcohol ingestion: prompt recognition and management in the emergency department [digest].

Gillian A Beauchamp, Matthew Valento, Jeremy Kim

Journal: Emergency medicine practice 2018;18(9 Suppl Points & Pearls):S1-S2

PMID: 28745842

Abstract

Identifying patients with potential toxic alcohol exposure and initiating appropriate management is critical to avoid significant patient morbidity. Sources of toxic alcohol exposure include ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropanol. Treatment considerations include the antidotes fomepizole and ethanol, and hemodialysis for removal of the parent compound and its toxic metabolites. Additional interventions include adjunctive therapies that may improve acidosis and enhance clearance of the toxic alcohol or metabolites. This issue reviews common sources of alcohol exposure, basic mechanisms of toxicity, physical examination and laboratory findings that may guide rapid assessment and management, and indications for treatment. [Points & Pearls is a digest of Emergency Medicine Practice].

Address: Adjunct Instructor, Oregon Health & Science University, Department of Emergency Medicine; Toxicology Fellow, Oregon and Alaska Poison Centers, Portland, OR.; Acting Assistant Professor, Division of Emergency Medicine, University of Washington; Interim Medical Director, Washington Poison Center, Seattle, WA.; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

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MeSH Terms: 2-Propanol, Alcoholism, Antidotes, Diagnosis, Differential, Emergency Service, Hospital, Ethanol, Ethylene Glycol, Ethylene Glycols, Fomepizole, Humans, Methanol, Propylene Glycol, Pyrazoles, Renal Dialysis