Case 8 – Automotive Acidosis

Case #8: Automotive Acidosis
Author: Christopher Lim, MD
Peer Reviewer: Steve Aks, MD

A 36 year old male is brought by ambulance to the emergency department after his wife found him unarousable. His wife states that he has a history of alcohol abuse and was found with a bottle of automotive fluid next to him. During transport to the hospital, the patient has one seizure-like episode. He was intubated en-route and given midazolam.

Vitals: Temp: 98.6, HR: 112, RR: 28, BP: 106/70, O2 sat: 98% on 100% FiO2

ABG: pH 6.6, pCO2 33, PO2 253, HCO3 3.3

What is the most likely toxicologic etiology of this patient’s presentation?
What other clinical symptoms or complications might you expect to see with this patient?
What is the treatment for this patient?
What further work-up is required?
What is the disposition of these patients?

References:

Barceloux DG, Bond GR, Krenzelok EP, et al. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol. 2002;40(4):415-46.

Litovitz T. The alcohols: ethanol, methanol, isopropanol, ethylene glycol. Pediatr Clin North Am. 1986 Apr;33(2):311-23.

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