Ethylene Glycol (Deep Dive MW R18) EM Clerkship
-
- Medicine
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
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
18 min