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Writer's picturePam Bartley, BSN, RN, CEN

CEN Tip of the Day - Methanol Toxicity

Updated: May 22, 2022


Cause:

o Accidental ingestions of windshield wiper fluid or intentional ingestions in those who confuse it for ethanol or who cannot afford ethanol.


S/S:

o Early—headache, dizziness, vertigo, visual impairment, mild inebriation, and anion gap acidosis.

o Late—tachycardia, hypotension, tachypnea (compensation for metabolic acidosis), abdominal pain, not sobering up, seizures, possible permanent vision impairment and rhabdomyolysis.


TX:

o Contact poison control or medical toxicologist.

o Fomepizole IV or Ethanol PO or IV.

o Sodium Bicarbonate IV to maintain pH > 7.30.

o Folic acid and Thiamine for vitamin replacement.

o Hemodialysis for refractory metabolic acidosis or hemodynamic deterioration.

o Gastric decontamination is not recommended to due rapid absorption.


References:

· https://litfl.com/methanol-toxicity/

· http://www.emdocs.net/em3am-methanol-toxicity/

· https://emergencymedicinecases.com/toxic-alcohols/



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