How To Treat ethylene Glycol Poisoning

Agent Characteristics

Appearance

Clear, colorless, syrupy (viscous) liquid at room temperature. Often colored fluorescent yellow-green when used in automotive antifreeze.

Description

A helpful industrial substance called ethylene glycol may be found in a variety of consumer goods. Antifreeze, certain stamp pad inks, ballpoint pens, solvents, paints, plastics, films, and cosmetics are a few examples. It may also serve as a delivery system for drugs. Because of its pleasant flavor, ethanol is frequently consumed, either intentionally or by mistake. In the body, ethylene glycol decomposes into harmful substances. The central nervous system (CNS), followed by the heart and kidneys, are the first organs that are impacted by ethylene glycol and its harmful byproducts. Taking in too much might result in death. Ethene glycol has no smell.

Methods of spreading

Indoor Air: Ethylene glycol can release into indoor air as a liquid spray (aerosol), vapor, or mist.

Water: Ethylene glycol can pollute water.

Food: Ethylene glycol can pollute food.

Outdoor Air: Ethylene glycol can release into outdoor air as a liquid spray (aerosol), vapor, or mist.

Agricultural: If ethylene glycol releases as a liquid spray (aerosol) or mist, it may pollute agricultural products. If ethylene glycol releases as a vapor, it is unlikely to pollute agricultural products.

Routes of exposure

Ingestion of ethylene glycol can cause systemic toxicity. Although breathing ethylene glycol fumes may irritate the eyes and lungs, systemic harm is not expected to result. Systemic harm is unlikely since ethylene glycol does not penetrate easily through the skin. Eye exposure is unlikely to cause systemic toxicity, although it may have negative local health consequences.

Signs/Symptoms

Time course

Ethylene glycol is quickly absorbed via the stomach after consumption (within 1 to 4 hours). At least 80% of the ethylene glycol that is absorbed undergoes chemical conversion into hazardous substances. The harmful health consequences of ethylene glycol poisoning are divided into three major, overlapping phases. After intake, Stage 1 (the neurological stage) lasts for 30 to 12 hours. Between 12 and 24 hours following consumption, stage 2 (also known as the cardiopulmonary stage) takes place. It takes place between 24 and 72 hours after intake to reach stage 3 (the renal stage). Alcohol use can greatly slow down the negative impacts on your health.

Effects of short-term exposure

Early ethylene glycol intoxication is similar to ethanol intoxication, although the patient's or victim's breath does not smell like alcohol. The initial negative health consequences of ethylene glycol intoxication include respiratory depression, central nervous system depression, intoxication, euphoria, and stupor. Gastrointestinal inflammation may result in nausea and vomiting. Severe poisoning can cause unconsciousness, reflex loss, seizures (rare), and inflammation of the brain's lining tissues.Acid builds up in the blood due to the harmful metabolic byproducts of ethylene glycol metabolism. Metabolic acidosis is the term for this process. These poisonous compounds can result in renal failure and have an impact on the cardiopulmonary system. Ethylene glycol poisoning frequently results in metabolic acidosis; however, the lack of acidosis does not rule out ethylene glycol toxicity.Serum ethylene glycol levels do not correlate well with clinical presentation.Untreated ethylene glycol poisoning can be fatal.

First Aid

General information

Initial treatment is primarily supportive. In the case of a large ingestion:

Treatment under a physician’s direction within the first 30 to 60 minutes should include an attempt to aspirate stomach contents.

As ethylene glycol absorbs rapidly from the gastrointestinal (GI) tract, gastric aspiration by use of a nasogastric tube may be useful.

Antidote

Fomepizole and ethanol are effective antidotes against ethylene glycol toxicity. Administer fomepizole or ethanol as soon as possible once the patient/victim is admitted to a medical care facility.

Eye

Immediately remove the patient/victim from the source of exposure.

Immediately wash eyes with large amounts of tepid water for at least 15 minutes.

Seek medical attention immediately.

Ingestion

Immediately remove the patient/victim from the source of exposure.

Ensure that the patient/victim has an unobstructed airway.

Do not induce vomiting (emesis).

Treat seizures with diazepam under a physician’s direction or per local EMS protocol.

Monitor heart function. Evaluate for low blood pressure (hypotension), abnormal heart rhythms (dysrhythmias), and reduced respiratory function (respiratory depression).

Evaluate for low blood sugar (hypoglycemia), electrolyte disturbances, and low oxygen levels (hypoxia).

Seek medical attention immediately.

Inhalation

Immediately remove the patient/victim from the source of exposure.

Evaluate respiratory function and pulse.

Ensure that the patient/victim has an unobstructed airway.

If shortness of breath occurs or breathing is difficult (dyspnea), administer oxygen.

Assist ventilation as required. Always use a barrier or bag-valve-mask device.

If breathing has ceased (apnea), provide artificial respiration.

Seek medical attention immediately.

Skin

Immediately remove the patient/victim from the source of exposure.

See the Decontamination section for patient/victim decontamination procedures.

Seek medical attention immediately.