Authors: Samantha Mills, Thomas Webster / Editor: Andrew Tabner, Graham Johnson / Reviewer: Samantha Mills / Codes: EnvC7, PhC2, PhC3, PhC4, PhC5, PhP2, SaC1, SaC3, SaP1, SaP2, SLO2, SLO3, XC3 / Published: 24/12/2022
A 45-year-old female attends the Emergency Department (ED) after having taken one and a half caps (approx. 50ml) of Ethanediol antifreeze, ingested approximately 7 hours prior to presentation.
The patient presents with mild light headedness but no other systemic symptoms. The ingestion was a pre-planned attempt to self-harm following recent exacerbating negative factors affecting her mental health.
On presentation she is haemodynamically stable, objectively and subjectively of low mood with persistent suicidal ideation. Examination in the Emergency Department returns normal findings.
Aside from ingesting antifreeze, the patient has taken her regular medication and no alcohol.
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Question 1 of 3
1. Question
What is the lethal dose of ethylene glycol for a 70kg adult?
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Question 2 of 3
2. Question
What initial investigations are required for this patient?
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Question 3 of 3
3. Question
The Antidote/treatment is Fomepizole or ethanol, but when should it be administered?
You've just arrived for your first ED shift, excited to be allocated to resus. The red phone rings. A 45-year-old female, amitriptyline overdose, P120, BP85/45, GCS 5, ETA 5 minutes.
Excellent module and a good reminder. Very robust and with a good structure- medical issue, symptoms and signs, management, and ongoing care advise. Thank you for this module!
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9 responses
Some challenging questions that will require access to toxbase to answer
New information about the dose of the antidote.
Useful information
Did this case after discussion about a patient regularly ingesting anti-freeze. Definitely learned something new.
good case
Good case overview
hard ones especially dosages
Excellent module and a good reminder. Very robust and with a good structure- medical issue, symptoms and signs, management, and ongoing care advise. Thank you for this module!
good learning points