Download METHANOL INGESTION (also know as Wood Alcohol)

METHANOL INGESTION
(also known as Wood Alcohol)
Methanol is contained in multiple products in home/garage.
Partial list…
gasoline antifreeze, radiator antifreeze
windshield washer fluid, deicers
paints
paint remover
varnishes
glass cleaner
canned fuels
copier fluids
Absorption can be through
ingestion
skin
inhalation
Methanol toxicity-Is due to it’s metabolites which are extremely toxic
Methanol is converted in the liver >>> formaldehyde >>> formic acid
Formic Acid is responsible for the toxic results (it disrupts the mitochondria ☺)
How much is toxic??
Onset of symptoms
anywhere from 40 minutes to 72 hours
delay in symptoms may occur if taken with ETOH
Signs and Symptoms (THREE main areas)
CNS
EYE
appear intoxicated
photophobia
lethargy
blurred vision
confusion/amnesia
see spots
coma
“snowstorm”
seizure
blind
headache
flashes
GI
N&V
Abdominal pain
Met Acidosis
SOB
tachypnea
shock
multisystem failure
death
TREATMENT
ABC, of course
**A and B
IV
EKG
Bicarb, 1 mEq/kg or more!
Rapid transport
No Activated charcoal (*check with medical control)
Do not induce vomiting
Try to obtain the product, when taken, how much!
P folder:METHANOL
Your patient is a “frequent flyer” of EMS.
He is seen most often because of his abuse of alcohol.
64 yo male, chronic alcohol abuse, hx of hypertension and COPD
As you arrive, of course you recognize your patient, he has been in the
system for years….Barry Frawlins
Barry appears to be “drunk” AGAIN!
He tells you he has not had his “usual Vodka” in over a day or two, but, “my
memory is gone”!
He says he had blurry vision, “like a snow storm”. Now he says he can’t see
“much at all”. “I have never been this drunk”.
This is why he had the McDonalds call 911.
He has been in their restroom for an hour or so “puking”
“I’ve never felt sick like this before”
Slurring words, unsteady on feet, has vomited on self
YOUR ASSESSMENT-WHAT DO YOU WANT TO KNOW?
VITALS
BP 132/84 p 102 r 30
A & O X2, Speech slurred
Blood sugar 122
Pulse ox 97%
EKG-Sinus tachycardia, occasional uniformed PVC
ANYTHING ELSE??
Pupils-dilated slightly, sluggish
Pain or other complaints?
Abdominal pain
abdomen soft
bowel sounds present
no diarrhea
No Respiratory complaints
What has he been drinking/eating??
No booze, no money
Eating out of McDonalds garbage (frequently seen doing this, not unusual)
When pushed….
needed something to drink, heard once that “other stuff gives you a good
buzz”
TREATMENT
Airway
IV
Continue to monitor EKG
? Bicarb
Rapid transport
Do not induce vomiting
No Activated Charcoal