Case Discussion - Accidental poisoning

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12 Oct 2016 - General

A middle aged man, working as a car mechanic, with no previous background of any medical conditions, was admitted due to accidental drinking of diluted anti-freeze solution, around 2 hours ago. He went for a run  after finishing work. After the exercise, he went back to his car and grab a bottle of water that he thought was a botlle of water, and drank it. After consuming of around 250ml, he did realised that the liquid he drank was indeed the diluted anti-freeze (containing ethylene glycol) !!!! He did prepared the diluted anti-freeze solution and put into his car a few days ago but he did forgotten about it. Subseqeuntly, he did contacted his family members to bring him to hospital. He was clinically well on arrival, with the only symptoms of minimal heartburn.  What is your management option ??? What antidote to be given ???

I can't remember if there is an specific antidote to ehylene glycol. Tell me if you know any.
You just need to give general and conservative management. Keep the patient on parental nutrition, nothing per oral other than drugs. IV antibiotics, Proton pump inhibitor and oral antacid syrup will help. Observe the patient closely for 48 hours. If any complication develops, treat it. If not, patient can be discharged. Stomach wash or such invasive procedure are better to be avoided. Is there...
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Thanks for sharing this case. Although this is not common in our region and I’ve never encountered a patient who had this type of poisoning. Anyway, at the ED, the team should be on standby intubation because the patient can go into rapid neurological deterioration. Patient should be hydrated with crystalloids and serum electrolytes (Na, K, Cl, Mg, Ca, serum osmolarity, osmolal gap) should be obtained especially if the patient is also alcoholic. Renal function test should also be done to check f...
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