A 40-year-old man presents after drinking windshield washer fluid. He is drowsy, RR 28, pH 7.12, bicarbonate 8 mmol/L, osmolar gap is elevated, and

Question

A 40-year-old man presents after drinking windshield washer fluid. He is drowsy, RR 28, pH 7.12, bicarbonate 8 mmol/L, osmolar gap is elevated, and anion gap is 29. Visual symptoms are reported. What is the most appropriate investigation?

Accepted Answer

Send serum methanol and ethylene glycol levels while calculating osmolar and anion gaps

Answer

Order D-dimer for pulmonary embolism

Answer

Use pulse oximetry to exclude toxic alcohol ingestion

Answer

Perform ankle radiographs

Answer

Request urine culture as the key test

Methanol poisoning — RCPSC EM MCQ

A 40-year-old man presents after drinking windshield washer fluid. He is drowsy, RR 28, pH 7.12, bicarbonate 8 mmol/L, osmolar gap is elevated, and anion gap is 29. Visual symptoms are reported. What is the most appropriate investigation?