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Clinical Correlations and Calculations Suggestions for Dealing the Physician’s Request for Quantitative Volatiles, Ethylene Glycol (EG) and Propylene Glycol (PG). 1. Ask for the clinical diagnosis. Is this an emergency? Is the patient stuporous or in coma? Is there a strong suspicion to believe ingestion has occurred WITHIN the last 12-24 hours? Remember, these subtances have relatively short elimination T˝ (2-5 hrs, except MeOH, 2-24 hrs) and may not be detectable in blood after 24 hrs. 2. Have common tests causing above been performed?
3. For MeOH poisoning: vomiting, coma, seizures, visual disturbances, motor restlessness, etc. 4. For EG or PG poisoning: altered mental “Stat”us, acidosis, seizures, coma. Appears drunk but no ETOH smell on breath. EG: Renal failure and decreased serum calcium, urinary calcium oxalate crystals (late phase). PG: especially toxic at low concentrations in adults with impaired renal function and in children.
6. Have the following information available to discuss potentially toxic ingestions:
7. If still in doubt, consult with your chief
resident or the attending on call. |
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