Ethylene Glycol (Deep Dive MW R18‪)‬ EM Clerkship

Phase One: CNS









* Ataxia, Slurred Speech, Confusion, N/V, Seizures









Phase Two: Cardiopulmonary









* CHF, Cardiogenic Shock/Hypotension, Pulmonary Edema, ARDS









Phase Three: Renal









* Flank pain, Hematuria, Oliguria, Renal Failure









Diagnosis:









* HIGH INDEX OF SUSPICION







* Ethylene Glycol Serum Level







* Elevated Osmolar Gap







* Serial Anion Gap Measurements









Treatment:









* Fomepizole or Ethanol to prevent breakdown to toxic glycolic acid/oxalic acid







* Hemodialysis







* Consider Bicarb drip, pyridoxine, and thiamine

















Further Reading:







EMCrit Toxic Alcohols