Research Information System
20. Ulusal Acil Tıp Kongresi & 11th Intercontinental Emergency Medicine Congress & 11th International Critical Care and Emergency Medicine Congress, Antalya, Turkey, 16 - 19 May 2024, pp.853, (Summary Text)
Ref No: 9169
Oh no, I drank alcohol, I don't see: Methanol poisoning
ABDİL ÇOŞKUN 1 , MURTAZA KAYA 1 , HARUN YILDIRIM 1 , ALİ HALICI 1 , ERTAN SÖNMEZ 1
Introduction and Purpose: Methanol , although commonly used in industrial settings, is predominantly seen in our country as a result of illegal bootleg alcohol consumption.Methanol, a
colorless and odorless substance, is unfortunately difficult to differentiate from ethanol when ingested orally . Due to its low cost, it is preferred in the production of bootleg alcohol. Methanol
poisoning is associated with high mortality, emphasizing the importance of early suspicion by emergency physicians. We aimed to present our patient diagnosed with methanol poisoning as a
case study in order to refresh and update our knowledge on the management of methanol poisoning.
Materials and Methods: Case: A 21 year old male patient presented to our emergency department with complaints of blurred vision, and vomiting. He denied substance use. He
reported drinking a bootleg alcohol beverage (50 cl of whiskey) two days prior. The patient appeared moderately toxic with pale skin, and hypotension was noted. Systemic examination is
normal.Blood tests revealed significant metabolic acidosis with an increased anion gap and decreased bicarbonate levels.A forensic examination form has been completed for the patient.
Suspected bootleg alcohol consumption history, visual problems, high anion gap metabolic acidosis in blood results, and negative blood ethanol levels led to suspicion of methanol
poisoning in the patient. The patient has been placed under hemodynamic monitoring, IV fluid, bicarbonate, IV ethanol and hemodialysis.
Results and Conclusion: In the management of methanol intoxication in the emergency department, the following points should be promptly considered:1.Secure the airway
appropriately in severely intoxicated patients. 2.Treat hypotension with intravenous crystalloid. 3. For those with metabolic acidosis (blood pH <7.25, anion gap >24), administer 1 to 2 mEq/kg
IV bicarbonate.4. Alcohol dehydrogenase (ADH) inhibition: Use fomepizole or ethanol (if fomepizole is unavailable)5. Hemodialysis enhances the elimination of primary alcohol and
metabolites. It is indicated in cases of metabolic acidosis independent of toxic methanol concentration (pH <7.25, anion gap >24), serum methanol concentration >50 mg/dL, and visual
disturbances.6. Co-factor therapy: administer leucovorin 50 mg IV or folic acid 50 mg IV every six hours. Methanol poisoning is a serious and potentially fatal condition. Emergency physicians
should be cautious in diagnosing methanol poisoning and knowledgeable in its treatment.
Keywords: methanol, poisoning. emergency medicine