Ethylene glycol
CPT4 code
Name of the Procedure:
Ethylene Glycol Poisoning Treatment
Common name(s): EG Poisoning Treatment
Technical or Medical Terms: Ethylene Glycol Intoxication Management
Summary
Ethylene glycol poisoning treatment is an urgent medical intervention needed when someone ingests ethylene glycol, a toxic substance found in antifreeze and other industrial products. The procedure involves a combination of treatments to prevent the poison's absorption and counteract its effects on the body.
Purpose
Ethylene glycol poisoning can lead to severe metabolic acidosis, kidney failure, and even death if not treated promptly. The goals of the treatment are to prevent the body from metabolizing ethylene glycol into more toxic compounds and to support the affected organs.
Indications
- Ingesting antifreeze or other products containing ethylene glycol.
- Symptoms like nausea, vomiting, intoxication, metabolic acidosis, or kidney failure.
- Laboratory tests indicating elevated levels of ethylene glycol in the blood.
Preparation
- No specific preparations for the patient as the condition is usually an emergency.
- Blood tests to measure ethylene glycol concentration, kidney function, and acid-base status.
Procedure Description
- Initial Assessment: Quickly assess the patient's clinical status, including vital signs and neurologic function.
- Stabilization: Support airway, breathing, and circulation as needed.
- Administration of Antidotes:
- Fomepizole or Ethanol: These drugs inhibit the enzyme alcohol dehydrogenase, preventing ethylene glycol from being metabolized into toxic compounds.
- Bicarbonate Therapy: To correct severe metabolic acidosis.
- Hemodialysis: In severe cases, hemodialysis may be required to quickly remove ethylene glycol and its toxic metabolites from the blood.
- Adjunctive Therapies: Thiamine and pyridoxine may be administered to support metabolism and renal function.
Duration
The treatment process can take several hours to days, depending on the severity of the poisoning and the patient's response to therapy.
Setting
This procedure is performed in a hospital setting, often in the emergency department or intensive care unit.
Personnel
- Emergency Physicians
- Intensivists
- Toxicologists
- Nurses
- Nephrologists (for hemodialysis)
Risks and Complications
- Allergic reactions to antidotes
- Complications from hemodialysis
- Long-term kidney damage
- Metabolic imbalances
Benefits
- Preventing severe organ damage
- Reducing the risk of death
- Stabilizing metabolic functions
Recovery
- Continuous monitoring in the hospital for signs of recovery.
- Renal function tests to monitor for potential kidney damage.
- Possible restrictions on activity depending on the extent of organ involvement.
- Follow-up appointments to ensure complete recovery and address any residual effects.
Alternatives
- If antidotes are unavailable, immediate hemodialysis might be the first line of treatment.
- Alternative supportive care including IV fluids and symptomatic treatment.
Patient Experience
- Patients might experience discomfort due to intravenous lines and monitoring equipment.
- Mild to moderate pain may occur at the site of IV insertion.
- Continuous monitoring can feel intrusive but is necessary for effective treatment.
- Pain management strategies and comfort measures are employed to make the patient as comfortable as possible.