151 - Toxic Alcohols

alcohol poisoning can result in metabolic acidosis, renal failure, blindness, central nervous system (CNS) injury, pulmonary edema, or death. Ethylene glycol is present in antifreeze solutions, deicing solutions, foam stabilizers, and chemical solvents. Methanol is a component of windshield-washing solutions, gas-line antifreeze solutions, solvents, and brake cleaners. Isopropanol is found in rubbing alcohol, aerosols, and other cosmetic products. Propylene glycol is commonly found as a diluent in parenteral medications such as phenytoin, diazepam, and lorazepam. The other toxic glycols can be found in various household and industrial cleaners, paints, resins, and solvents. More than 35,000 toxic alcohol exposures are reported yearly to the American Association of Poison Control Centers. Most cases are individual poisonings. However, contamination of beverages or pharmaceutical products has resulted in epidemic poisonings, including two significant outbreaks, in India and in Haiti in the 1990s, from diethylene glycol that affected hundreds of victims. Definitive laboratory confirmation of toxic alcohol poisoning is usually not immediately available to the emergency physician. However, early recognition of poisoning and emergency department (ED)–initiated interventions significantly improve patient outcomes and reduce the occurrence of alcohol-specific complications.