Age and Sex edits from the Medicare Code Editor alert you to codes that are used only with patients of a specific age or sex, helping to ensure accurate reporting Present on Admission symbol highlights the diseases that will always be coded as present [books.google.com]

All three patients had presented late (>24–72 hours) with established renal failure. [emj.bmj.com]

Case presentation A 55 year-old male presented to a local emergency department in Panama with abdominal pain, vomiting and diarrhea. He had been using an prescription cough syrup in the preceding days to treat a viral illness. [calpoison.org]

In developing its educational products ATSDR has made a diligent effort to ensure the accuracy and the currency of the presented information. [atsdr.cdc.gov]

• Gastric Lavage

  There is no role for activated charcoal, cathartics or gastric lavage in ethylene glycol intoxication. Alcoholics and patients likely to be malnourished should be given thiamine and pyridoxine. [renalandurologynews.com]

  Treatment included gastric lavage, charcoal, and intravenous ethanol. The serum ethanol concentration was maintained between 17 and 22 mmol/L (76–103 mg/dL). [clinchem.aaccjnls.org]

  Ethylene glycol is rapidly absorbed from the stomach, making treatment with gastric lavage and syrup of ipecac ineffective. 3, 6 Likewise, it requires large amounts of activated charcoal to bind relatively small amounts of ethylene glycol, and the therapeutic [aafp.org]

• Diarrhea

  The first phase typically involves gastrointestinal effects such as nausea, vomiting, abdominal pain and diarrhea. Patients may be inebriated and mild hypotension has been reported. [calpoison.org]

  » What Is the Connection Between Infant Constipation, Diarrhea, and Autism? Please read these pages before emailing me a teary "help me" plea. [gutsense.org]

• Renal Insufficiency

  The precipitation of calcium oxalate in the renal cortex results in decreased glomerular filtration and renal insufficiency. The formation of these crystals consumes circulating calcium, and hypocalcemia may occur, though this is uncommon. [emedicine.medscape.com]

  These patients would require close monitoring for the development of renal insufficiency or acidosis. [renalandurologynews.com]

• Anuria

  If left untreated, patients may die within a week after the onset of anuria. Additionally, mild to moderate hepatotoxicity is often seen. [calpoison.org]

  Most renal damage is reversible and renal recovery, which may take a few months, is the norm even after anuria. [renalandurologynews.com]

• Renal Injury

  The degree of renal injury predicts the severity of the third phase of this poisoning, which are neurologic complications. These effects can be delayed until 1-2 weeks post-ingestion. Multiple varying neurologic sequelae have been described. [calpoison.org]

• Seizure

  Seizures — control with IV benzodiazepines, and intubate and ventilate as required (see above). [lifeinthefastlane.com]

  […] antidote will prevent the production of toxic metabolites and prevent the rise in anion gap.Typically, after a brief period of inebriation due to the intoxicating effect of ethylene glycol itself, metabolic acidosis develops, followed by tachypnoea, coma, seizures [southtees.nhs.uk]

  Other issues which present in cases of toxic levels of exposure include seizures, coma and renal failure. Populations that are at particular risk are small children. [sciencing.com]

  About 3-12 hours after ingestion, a person can develop seizures, tremors, rapid shallow breathing, and worsening sleepiness that may progress to coma and death. Kidney failure is a well-known complication of EG poisoning. [acmt.net]

  Effects of ingestion are inebriation, coma, seizures, meningismus, muscle spasms, and paralysis of the extraocular muscles. Also causes tachycardia, hyperventilation, ARDS, and heart failure. [emdocs.net]

• Convulsions

  Stage 1 (30 minutes to 12 hours after ingestion) Apparent intoxication with alcohol (but no ethanol on breath), nausea, vomiting and haematemesis, coma and convulsions (often focal). ataxia, ophthalmoplegia, papilloedema, hypotonia, hyporeflexia, myoclonic [southtees.nhs.uk]

  Symptoms may include nausea, vomiting, convulsions, stupor (decreased level of alertness), or even coma. [medlineplus.gov]

  Buell, Sterling et al. 1998) ataxia slurred speech drowsiness irritation restlessness disorientation The ATSDR article continues: Possible sequelae of severe poisonings (Walder and Tyler 1994; Hantson, Vanbinst et al. 2002) include myoclonic jerks convulsions [inspectapedia.com]

  Neurological manifestations are apparent within 0.5–12 h of ingestion and include inebriation in the absence of detectable ethanol on breath or in blood, nausea, vomiting, nystagmus, papilledema, depressed reflexes, convulsions, and coma. [clinchem.aaccjnls.org]

• Confusion

  The patient in case 3 presented with a confusing picture of unexplained metabolic acidosis and renal failure. [clinchem.aaccjnls.org]

  PG is widely available and has many legitimate uses, such as antifreeze and windshield washers, and there can be confusion regarding whether methanol, ethylene glycol, or PG is present in the product. [clinicaladvisor.com]

  Unfortunately, the needle-shaped forms areoften confused with hippurate. The dihydrate, envelope-shaped form is only present at high concentrations of calcium and oxalate, and willtransform to the monohydrate. [aafp.org]

• Nystagmus

  This state of alcohol intoxication occurs within 1-2 hours and is characterized by euphoria, nystagmus, drowsiness, nausea and vomiting. The patient has a high osmolar gap. [lifeinthefastlane.com]

  Neurological manifestations are apparent within 0.5–12 h of ingestion and include inebriation in the absence of detectable ethanol on breath or in blood, nausea, vomiting, nystagmus, papilledema, depressed reflexes, convulsions, and coma. [clinchem.aaccjnls.org]

• Encephalopathy

  The differential diagnosis is relatively broad, with imaging features and clinical presentation similar to a number of other conditions including: other toxic encephalopathies metabolic encephalopathies posterior reversible encephalopathy syndrome (PRES [radiopaedia.org]

  Complete recovery from ethylene glycol poisoning with aggressive treatment, however, has been reported even after severe encephalopathy ( 19 ) or profound acidemia with a serum pH of 6.46 ( 13 ) toxicokinetic evaluation of ethylene glycol elimination [clinchem.aaccjnls.org]

Treatment Current practice guidelines for initiating treatment of ethylene glycol poisoning have been published by the American Academy of Clinical Toxicology (AACT) 4 and are listed in Table 3. [aafp.org]

A new alcohol dehydrogenase inhibitor, fomepizole (brand name: Antizol), was approved in 1997 for the treatment of ethylene glycol poisoning in patients at least 12 years old. It has also been used successfully with younger children. [medicinenet.com]

The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. [medicinesinpregnancy.org]

Serious effects of poisoning can be prevented if medical treatments are provided soon after ingestion. Top of Page Is there an antidote for ethylene glycol poisoning? Ethanol and fomepizole are used as antidotes in the treatment of EG poisoning. [acmt.net]

Treatment and prognosis With prompt and appropriate therapy, ethylene glycol toxicity can be minimized. Treatment is primarily with haemodialysis, administration of bicarbonate (to counteract metabolic acidosis), and fomepizole 1. [radiopaedia.org]

Although the test is not a good indicator of prognosis, a documented level above 20 mg per dL (3 mmol per L) is an indication for treatment with fomepizole (Antizol). 4 The excretion of calcium oxalate crystals in the urine is a finding in approximately [aafp.org]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]

Dieu-Thu Nguyen-Khoa, MD; Vitamin K Deficiency; Etiology; Medscape Reference [ link ]. If push comes to shove, don't fight your doctors over this contentious topic — just refer them to these links. These references are as mainstream as it gets. [gutsense.org]

Epidemiology The majority of documented cases of DEG poisoning have been epidemics where DEG was substituted in pharmaceutical preparations for the more expensive, but nontoxic glycols or glycerins. [calpoison.org]

Epidemiology According to the 2012 data from the United States Poison Control Center, 16,458 cases of isopropyl alcohol ingestions were reported. 8,773 of these cases were classified as a “toxicity” with 65 patients experiencing “major morbidity,” but [emdocs.net]

Epidemiology Frequency United States Ethylene glycol is a relatively common cause of overdose in US emergency departments. [emedicine.medscape.com]

It doesn’t take a PhD in epidemiology to infer a possible connection between these two happenings. [gutsense.org]

Pathophysiology There is limited data regarding DEG and most information is derived from published experimental studies. DEG is readily absorbed orally. Dermal absorption has been reported through damaged skin involving a large surface area. [calpoison.org]

Pathophysiology Methanol also called methyl alcohol is found in windshield wiper fluid, de-icing products, paint removers, photocopying fluid, shellacs, and embalming fluid. [emdocs.net]

Pathophysiology [2] Like the other toxic alcohols mentioned above, ethylene glycol is a parent compound that exerts most of its toxicity by conversion to metabolites. [emedicine.medscape.com]

Pathophysiology Toxicity results from the depressant effects of ethylene glycol on the central nervous system(CNS). Metabolic acidosis and renal failure are caused by the conversion of ethylene glycol to noxious metabolites. [aafp.org]

These antidotes work by preventing the body from metabolizing EG into even more dangerous toxins. By stopping the breakdown of EG, further damage to the body may be prevented, but the antidotes do not reverse any damage that has already occurred. [acmt.net]

(NCHEC) CHES : The Centers for Disease Control and Prevention is a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. [atsdr.cdc.gov]

In skin and hair care products, Propylene Glycol acts by retaining the moisture content of skin or the formula, preventing the escape of moisture or water. [truthinaging.com]