A Shameless Toxic Alcohol Ingestion

Santiago Batista Minaya MD, PGY-2
Department of Emergency Medicine
Saint Joseph’s Regional Medical Center

Key Points:

  • Etylene glycol is found in anti-freeze, auto coolant, and de-icers
  • Rapid GI absorption — Activated charcoal is not recommended
  • Toxic Metabolite: Oxalic Acid
  • Clinically: appears intoxicated, high anion gap metabolic acidosis, elevated osmolar gap, AKI/ATN, obtunded and comatose in late presentation
  • Tx: Formepizole, Ethanol, Vit B1/B6, hemodialysis