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Management of alcohol poisoning 

Management of alcohol poisoning
Chapter:
Management of alcohol poisoning
Author(s):

Knut Erik Hovda

and Dag Jacobsen

DOI:
10.1093/med/9780199600830.003.0327
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date: 16 October 2021

Ethyl alcohol poisoning is by far the most common alcohol poisoning, and it can usually be handled by simple symptomatic treatment. Methanol and ethylene glycol poisonings share many characteristics, often presenting with a metabolic acidosis of unknown origin. Obtaining the diagnosis could be difficult, and assays for the toxic alcohol are seldom available at hand. The diagnosis should thus be supported by the use of the anion- and osmolal gaps, and/or a simple and specific formate enzymatic method measuring the toxic metabolite itself. A delayed diagnosis of poisonings will often have fatal consequences, in spite of effective treatment available. Treatment mainly consists of buffer, antidote, haemodialysis, and folinic acid (if methanol is suspected) in addition to supportive care. The long-term prognosis of cerebral (unless hypoxic damage)—and kidney function in ethylene glycol poisonings - is good given adequate treatment. Diethylene glycol is also highly toxic, but the knowledge on toxicity is limited. We recommend treatment similar to ethylene glycol poisonings. Other alcohol poisonings are less severe, and will usually present without pronounced metabolic acidosis.

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