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Tip of the Week: Antifreeze Poisonings ToxTidbit with Lisa Booze
Most poisoning episodes offer a unique chance for EMTs and paramedics to use their observation skills in relaying important parts of the patient history and surroundings to the emergency department staff. Incidents of antifreeze ingestion are prime examples of this.
In many cases seen by poison control centers, long term alcohol abusers drink antifreeze seeking an inexpensive source of alcohol. Unfortunately, the ethylene glycol is fatal in extremely small doses and does appear to be a simple case of intoxication on first glance to a medical provider.
EMS providers should be careful not to simply assume the town drunk is up to his or her regular tricks when they show up for another transport to the hospital. Ask careful questions about the specific drink of choice this evening. Observe the surroundings for evidence of an antifreeze container or other chemical source of potential intoxicants. Be prepared to relay these suspicions to online medical control or to the ER nurse upon arrival.
Ethylene Glycol (the key ingredient in antifreeze and some other common chemicals) is extremely toxic but can be countered when recognized early enough as a cause of overdose or poisoning. The lab tests and signs of metabolic acidosis are just some of the markers that distinguish this from other types of alcohol based poisonings including wood alcohol (methanol) ingestion.
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