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]

• Pain

  Stage 3 (24-72 hours after ingestion) Flank pain, renal angle tenderness, acute tubular necrosis, hypocalcaemia (as a consequence of calcium complexing with oxalate), calcium oxalate monohydrate crystalluria, hyperkalaemia and hypomagnesaemia develop. [southtees.nhs.uk]

  EG can cause nausea, vomiting, slurred speech, dizziness, unsteady gait, and abdominal pain. A person who is poisoned with EG may appear drunk. They may also have a sweet aromatic odor to their breath. [acmt.net]

  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]

  This also causes flank pain and oliguria. Isopropanol is the most commonly ingested toxic alcohol in the United States. Isopropyl alcohol is found in solvents and disinfectants. [emdocs.net]

• Falling

  Thereafter, as the glycol is metabolised to acids, the osmolar gap will fall while the patient’s anion gap will climb and acidosis worsens. [southtees.nhs.uk]

  Glycolate does not contribute to the osmolar gap so that as the ethylene glycol is metabolized to glycolate, the osmolar gap will in fact fall. Therefore patients who present late after an ingestion, may have a normal osmolar gap. Figure 3. [renalandurologynews.com]

  […] meaning it causes bleedings not because of its contact with the stomach's mucosal membrane, but because it reduces the coagulation of the blood, a frequent cause of death or disability in older adult caused by internal bleedings related to accidental falls [gutsense.org]

  He reported ingesting about “20 ounces [∼56 mL] of half-strength” antifreeze, cutting his wrists with a dull knife, and falling down a flight of stairs. [clinchem.aaccjnls.org]

• 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]

• 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]

• 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]

• Stupor

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

• Papilledema

  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]

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]