Cause:
o Accidental ingestions of windshield wiper fluid or intentional ingestions in those who confuse it for ethanol or who cannot afford ethanol.
S/S:
o Early—headache, dizziness, vertigo, visual impairment, mild inebriation, and anion gap acidosis.
o Late—tachycardia, hypotension, tachypnea (compensation for metabolic acidosis), abdominal pain, not sobering up, seizures, possible permanent vision impairment and rhabdomyolysis.
TX:
o Contact poison control or medical toxicologist.
o Fomepizole IV or Ethanol PO or IV.
o Sodium Bicarbonate IV to maintain pH > 7.30.
o Folic acid and Thiamine for vitamin replacement.
o Hemodialysis for refractory metabolic acidosis or hemodynamic deterioration.
o Gastric decontamination is not recommended to due rapid absorption.
References:
· https://litfl.com/methanol-toxicity/
· http://www.emdocs.net/em3am-methanol-toxicity/
· https://emergencymedicinecases.com/toxic-alcohols/