Ethylene Glycol

Question 1

EG: Life Threats

Calcium oxalate crystal deposition
Kidney/ heart/ muscle/ brain

Risk Assessment: >1ml/kg

Answer 1

Acute:
-CNS depression/ Seizure
-Renal Failure
-Cardiac arrhythmia prolonged QT
-CVS: tachy/ hypo/ dyspnea
- Electrolytes: hyperK/ Hypo Ca/ Hypo Mg
Late:
-CN Neuropathies - II, V, VII, VIII, IX, X, XII

Question 2

EG: Metabolic derangement

Answer 2

HAGMA
Lactic acidosis
Osmolar gap >10
Bicarb-low
Renal Failure
Hypocalcaemia
EG level
CHECK ETHANOL LEVEL

Question 3

EG: Antidote

Answer 3

ETHANOL
NG/ PO: aim Etoh Level 22-44 mmol/L
Loading: 1.8ml/kg 43% = 3x 40 ml shots vodka
Maintain: 02.-0.4 ml/kg/hr
IV: 
load: 8 mls/kg 10%
Main: 1-2mls/kg/hr
FOMEPIZOLE: not available

Question 4

EG: Enhanced Elimination dialysis indications

Answer 4

Large ingestion
Renal impairment
Labs
- pH10
- EG level > 8

Cease when
no acidaemia
Osmolar gap < 3.2

repeat VBG q 4 hr for 24 hrs to ensure no recurrence

Question 5

EG: Disposition

Answer 5

Acute: ICU/ HDU
Chronic: CN followup

Question 6

EG: Controversial Adjunct

Answer 6

Pyridoxine (Vitamin B6)

IV 50 mg q 6 hr