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    Ethylene glycol intoxication

    Intoxication - ethylene glycol; Ethylene glycol poisoning

    Ethylene glycol is a colorless, odorless, sweet-tasting chemical found in many household products, including antifreeze, deicing products, detergents, paints, and cosmetics. It is poisonous if swallowed.

    This is for information only and not for use in the treatment or management of an actual poison exposure.In the United States, call 1-800-222-1222 to speak with a local poison control center. This hotline number will let you talk to experts in poisoning. They will give you further instructions.

    Causes

    Ethylene glycol may be swallowed accidentally, or it may be taken deliberately in a suicide attempt or as a substitute for drinking alcohol (ethanol).

    Symptoms

    The first symptom of ethylene glycol ingestion is similar to the feeling caused by drinking alcohol (ethanol). Within a few hours, more toxic effects become apparent. Symptoms may include nausea, vomiting, convulsions, stupor, or even coma.

    An overdose of ethylene glycol can damage the brain, lungs, liver, kidneys, and lungs. The poisoning causes disturbances in the body's chemistry, including metabolic acidosis. The disturbances may be severe enough to cause profound shock, organ failure, and death.

    As little as 120 milliliters (approximately 4 fluid ounces) of ethylene glycol may be enough to kill an average-sized man.

    Exams and Tests

    Ethylene glycol toxicity should be suspected in anyone who is severely ill after drinking an unknown substance, especially if they at first appear drunk andyou cannotsmell alcohol on their breath.

    Diagnosis of ethylene glycol toxicity is usually made through a combination of blood, urine, and other tests such as:

    • Arterial blood gas analysis
    • CHEM-7
    • Chest x-ray (shows fluids in the lungs)
    • Complete blood count (CBC)
    • CT scan (shows brain swelling)
    • EKG
    • Ethylene glycol test
    • Ketones - blood
    • Osmolality
    • Toxicology screen
    • Urinalysis

    Tests will show increased levels of ethylene glycol, blood chemical disturbances, and possible signs of kidney failure and muscle or liver damage.

    Treatment

    Most people with ethylene glycol poisoning need to be admitted to a hospital's intensive care unit (ICU) for close monitoring. A breathing machine (respirator) may be needed.

    Those who recently swallowed the ethylene glycol may have their stomach pumped (suctioned). This can help remove some of the poison.

    Other treatments may include:

    • Activated charcoal
    • Sodium bicarbonate solution given through a vein (IV) to reverse severe acidosis
    • Antidotes that slow the formation of the poisonous by-products in the body

    In severe cases, dialysis may be used to directly remove the ethylene glycol and other poisonous substances from the blood. Dialysis reduces the time needed for the body to remove the toxins. Dialysis is also needed by patients who develop severe kidney failure as a result of poisoning. It may be needed for many months afterwards.

    Outlook (Prognosis)

    How well a person does depends on how quickly treatment is received, among other things. When treatment is delayed, this type of poisoning can be deadly.

    Possible Complications

    • Coma
    • Death
    • Kidney failure
    • Shock

    When to Contact a Medical Professional

    Ethylene glycol ingestion is a medical emergency. If you suspect possible poisoning, seek emergency care immediately. Do not wait for poisoning symptoms to develop.

    In the United States, call 1-800-222-1222 to speak with a local poison control center. This hotline number will let you talk to experts in poisoning. They will give you further instructions.

    This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention.You can call24 hours a day, 7 days a week.

    Take the container with you to the hospital, if possible.

    Prevention

    Keep substances that contain ethylene glycol out of the reach of children.

    References

    Ford MD, Clinical Toxicology. 1st ed. Philadelphia, Pa: WB Saunders; 2001.

    Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009.

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    • Poisons

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      • Poisons

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      Tests for Ethylene glycol intoxication

        Review Date: 1/30/2013

        Reviewed By: Eric Perez, MD, St. Luke's / Roosevelt Hospital Center, NY, NY, and Pegasus Emergency Group (Meadowlands and Hunterdon Medical Centers), NJ. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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