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