To obtain emergency consultation with a medical toxicologist, in the United States, call 1-800-222-1222 for the nearest regional poison control center. Contact information for poison control centers around the world is available at the WHO website and in the UpToDate topic on regional poison control centers (society guideline links). |
Clinical features |
Ensure that "alcohol" ingested is ethanol and not another toxic alcohol (eg, methanol, ethylene glycol): clinical signs of toxic alcohol include a serum osmolal gap out of proportion to the ethanol level soon after ingestion, and development of severe anion gap metabolic acidosis |
Ethanol ingestion in young children carries a significant risk for hypoglycemia |
Common findings:
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Other findings:
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Diagnostic evaluation |
Obtain fingerstick blood glucose in all patients with altered mental status and young children |
Measure blood ethanol level* |
Possible toxic alcohol ingestion: serum electrolytes, BUN, creatinine, serum osmolality, serum calcium, blood gas, serum methanol and ethylene glycol levels |
Other studies based on clinical presentation¶ |
Treatment |
Secure airway and support breathing as needed |
Treat hypoglycemia with 0.25 grams/kg IV dextrose bolus (maximum single dose 25 grams). Glucagon is ineffective for ethanol-induced hypoglycemia in children.Δ The volume and concentration of glucose bolus is infused slowly at 2 to 3 mL per minute and based upon ageΔ:
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After reversal of hypoglycemia, maintain blood glucose by administering continuous dextrose infusion with ¼ or ½ normal saline, depending upon maintenance sodium requirements, to maintain blood glucose greater than 60 mg/dL (3.33 mmol/L) or, in conscious patients who are able to drink and swallow safely, provide a regular dietΔ |
Treat hypovolemia with intravenous bolus of normal saline or lactated Ringer's solution 20 mL/kg (maximum 1 L), repeat as needed |
Rewarm based on core body temperature |
* All infants and young children with significant ingestion. May provide estimate of symptom duration in moderate to severely intoxicated adolescents.
¶ Refer to UpToDate topics on ethanol poisoning in children and adolescents.
Δ Refer to UpToDate topics on toxic effects of ethanol in children and UpToDate rapid overview and topics on management of hypoglycemia in children.Do you want to add Medilib to your home screen?