Deep Dive MW R18

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