Home > The diagnosis and management of toxic alcohol poisoning in the emergency department: a review article.

Gallagher, Nicholas and Edwards, Frank J . (2019) The diagnosis and management of toxic alcohol poisoning in the emergency department: a review article. Advanced Journal of Emergency Medicine, 3 (3) e28. doi: 10.22114/ajem.v0i0.153

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC66835...

Context: This review discusses the range of clinical presentations seen with poisonings by the major toxic alcohols--methanol, ethylene glycol, and isopropyl alcohol. It outlines a straightforward diagnostic strategy and discusses in detail the current treatment recommendations.

Evidence acquisition: The authors conducted a literature search of primary and secondary sources related to the topic. For treatment recommendations, search restrictions included articles published between 2008 and 2019. For background information, search restrictions included articles written from 1990 - present.

Results: This review discusses in detail how the diagnosis can be made via clinical signs, symptoms, and laboratory values as well as the most recent treatment recommendations. This paper will also discuss the limitations of the emergency department workup and how the absence of particular laboratory findings does not necessarily rule out the diagnosis.

Conclusion: Poisoning with methanol, ethylene glycol, and isopropanol present diagnostic and therapeutic challenges to emergency physicians. Toxic alcohol poisonings lead to an elevated osmolar gap and, with the exception of Isopropanol, a metabolic acidosis. In order for the timely initiation of life-saving treatment, emergency physicians need a solid understanding of the pathophysiology, clinical presentation, laboratory workup, and treatment.


Item Type:Evidence resource
Publication Type:Review
Drug Type:Alcohol
Intervention Type:AOD disorder, AOD disorder treatment method, AOD disorder harm reduction
Date:2019
Pages:e28
Page Range:e28
Volume:3
Number:3
EndNote:View
Subjects:A Substance use, abuse, and dependence > Prevalence > Substance use behaviour > Alcohol consumption
B Substances > Alcohol
G Health and disease > Substance use disorder > Alcohol use > Alcohol intoxication
G Health and disease > Substance use disorder > Drug use > Drug intoxication > Poisoning (overdose)
J Health care, prevention and rehabilitation > Patient care management
J Health care, prevention and rehabilitation > Care by type of problem > Emergency care
J Health care, prevention and rehabilitation > Health care programme or facility > Hospital
T Demographic characteristics > Doctor

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