Ethylene glycol vapor poisoning

Ethylene glycol is a water-soluble liquid, sweet to the taste, odorless, colorless. The substance is a component of paintwork materials, plastic products, pharmaceuticals, antifreeze, brake fluids and much more.

Ethylene glycol intoxication most often occurs in manufacturing facilities.

Symptoms of the ethylene glycol poisoning

The main symptoms of inhalation toxin injury include:

• Nausea and vomiting.
• Ataxia.
• Drowsiness.
• Nystagmus.
• Respiratory depression.

Many victims note that the exhaled air has a slight sweet flavor. The victim has a state of intoxication with all the resulting symptoms. The substance is rapidly absorbed into the systemic bloodstream, its concentration reaches a maximum in 2 hours after ingestion and in 4-12 hours when exposed to vapors. At this stage, the patient's condition is supplemented by such symptomatology:

• Tachypnoea.
• Arterial hypotension.
• Confusion.
• Drowsiness/excitement.
• Epileptic seizures.

• Comatose.

In 30% of cases, hypocalcemia and leukocytosis are observed. In particularly severe cases, the victim develops pulmonary edema, cardiomegaly, cyanosis, shock. Laboratory diagnosis reveals metabolic acidosis, renal failure, acute tubular necrosis.

Diagnostics of the ethylene glycol poisoning

Diagnosis of ethylene glycol vapor poisoning may include the following steps:

1. History taking: The doctor will talk to the victim or people in the vicinity to find out the circumstances of the incident. They may learn that the victim inhaled vapors containing ethylene glycol.
2. Physical Exam: The physician will perform a general physical examination to assess the casualty's condition, including breathing, skin, pulse and other important parameters.
3. Laboratory tests: Elevated levels of ethylene glycol metabolites such as glycolic acid may be found in the victim's blood. These tests help confirm the presence of poisoning and determine the extent of poisoning.
4. Instrumental investigations: Depending on the symptoms and condition of the victim, various instrumental investigations such as chest X-rays or CT scans may be ordered to assess the condition of the lungs and other organs.
5. Organ function assessment: Various tests are performed to assess organ function, such as kidney and liver function, to determine the presence and extent of organ failure.
6. Condition Monitoring: The victim may be placed on monitoring in the ICU for continuous monitoring of their condition, including breathing, heart rate, blood pressure, and other important indicators.

Treatment of the ethylene glycol poisoning

First aid for ethylene glycol poisoning should be given as soon as possible. Here is what you should do:

1. Call anambulance: Call an ambulance or emergency services immediately. Give the operator as much detail as possible about the situation and the condition of the injured person.
2. Moving to fresh air: If poisoning occurs indoors, move the victim to fresh air to avoid further exposure to the toxin.
3. Check for breathingand pulse: Check the casualty for breathing and pulse. If no breathing or pulse is detected, begin cardiopulmonary resuscitation (CPR).
4. Mouth and nose clearance: If the victim is not breathing, make sure their airway is clear of any obstruction such as vomit or mucus.
5. Gastric lavage: This can be done in a medical facility, but if the poisoning is recent and the victim is conscious, inducing vomiting can be tried to reduce the amount of substance in the bloodstream. However, this should not be done if the victim has lost consciousness, as it may aggravate the condition.
6. Givedrink: If the casualty is conscious and able to drink, give plenty of water to dilute the substance and promote its rapid elimination from the body.

Here's what specialized treatment at a medical facility for ethylene glycol poisoning might look like:

1. Gastric lavage: Once the victim is stabilized, gastric lavage may be performed to remove residual ethylene glycol. This procedure can be effective if done within the first few hours after poisoning.
2. Antidote administration: An antidote called fomepizole (Antizol) is used for ethylene glycol poisoning. It inhibits the action of enzymes responsible for metabolizing ethylene glycol into toxic compounds. In some cases, alcohol (ethanol) may also be used as an alternative antidote.
3. Symptomatic treatment: Doctors may provide symptomatic treatment to manage symptoms such as nausea, vomiting, abdominal pain, and others.
4. Hemodialysis: Hemodialysis may be required for ethylene glycol poisoning. Hemodialysis is an effective method of removing ethylene glycol and its toxic metabolites from the blood.
5. Monitoring and maintenance of vital functions: The victim will be continuously monitored with specialized medical devices to assess their condition, including respiratory status, pulse, blood pressure, and blood oxygen levels. Maintenance of vital functions of the body will be carried out throughout the treatment.