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Ethylene glycol poisoning (Clinical presentation (Dysarthria, N+V,…
Ethylene glycol
poisoning
Pathophysiology
Mainly found in antifreeze
Toxic effects due to metabolites
(glycoaldehyde, glycolic acid, oxalic acid)
Clinical
presentation
Dysarthria
N+V
Ataxia
Haematemesis
Seizures
Coma
Diagnosis
Examination
Abdo
Haematemesis, N+V
Neuro
Reduced GCS, dysarthria, ataxia,
seizures, coma
Cardio
Tachycardia, irregular pulse
Resp
Tachycardia, tachypnoea, bibasal crackles (oedema)
Investigations
Bloods
ABG (metabolic acidosis), FBC, CRP, U+E (renal failure),
Ca (LOW), LFT, clotting, toxicology (ethylene glycol)
Urine
Toxicology (oxalate crystals)
Bedside
Obs
ECG
BM
History
DH
Meds, allergies
FH
Psychiatric disorder,
substance misuse
PMH
Previous poisonings,
any psychiatric disorder
SH
Living arrangements, occupation,
smoking, alcohol, drugs
PC/HPC
Ingestion, dose timing,
intention, vomiting, symptoms
Management
Initial ABCDE
Definitive
Conservative
Infromation, advice, support
Monitoring (obs, ECG, bloods, neuro)
Consult TOXBASE, poisons info service
Medical
Antidote
Indication: all patients
E.g. ethanol (whisky, gin, vodka), fomepizole
Haemodialysis
Indication: severe poisoning
Definition
Ingestion of antifreeze to
a level to cause physical harm