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Toxic alcohol poisoning — RCPSC IM MCQ

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HardCritical CareToxic alcohol poisoningRCPSC IM

A 44-year-old found confused in a garage has pH 7.05, anion gap 32, osmolar gap 38 mOsm/kg, acute kidney injury and calcium-oxalate crystals. The ethylene-glycol level will not return for several hours. What is the best next action?

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Correct answer: A — Start antidote after poison-centre consultation and assess for dialysis

The best answer is “Start antidote after poison-centre consultation and assess for dialysis”. The biochemical pattern strongly suggests severe ethylene-glycol poisoning. Antidotal therapy and toxicology consultation should not wait for a delayed level, and severe acidosis or kidney injury may require dialysis; charcoal does not bind alcohols effectively and bicarbonate alone does not block toxic metabolism.

Reference: Ontario Poison Centre, toxic alcohol patient-care resource: https://www.ontariopoisoncentre.ca/siteassets/pdfs/english/protocols/toxic-alcohol-patient-resource-page-final-oct-2025.pdf