EM Cases · Toxic alcohols methanol ethylene glycol
Toxic alcohols — methanol-like dual-gap resus station
ACEM Fellowship OSCE resus station testing dual-gap recognition, immediate fomepizole dosing, cofactors, and EXTRIP dialysis activation.
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Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
Adult with reduced GCS, high anion-gap metabolic acidosis, osmolar gap, and visual disturbance after solvent ingestion.
Station brief
Format. Clinical-management (resus) station, 11 minutes — 4 minutes reading, 7 minutes active management. You are the EM consultant. Manage from handover; state actions and exact drug doses.
References3ShowHide
- [1]Brent J, McMartin K, Phillips S, et al. Fomepizole for the treatment of ethylene glycol poisoning. Methylpyrazole for Toxic Alcohols Study Group. N Engl J Med, 1999.PMID 10080845
- [2]Brent J, McMartin K, Phillips S, et al. Fomepizole for the treatment of methanol poisoning. N Engl J Med, 2001.PMID 11172179
- [3]Roberts DM, Yates C, Megarbane B, et al. Recommendations for the role of extracorporeal treatments in the management of acute methanol poisoning: a systematic review and consensus statement. Crit Care Med, 2015.PMID 25493973