Acute exposure

Inhalation

The victim should be removed from exposure and all contaminated clothing removed. The respiratory function should be assessed. Further treatment is symptomatic and supportive. See below for management of systemic effects.

Dermal

Contaminated clothing should be removed and the skin thoroughly irrigated with water or saline. Further treatment is symptomatic and supportive. See below for management of systemic effects.

The eyes should be thoroughly irrigated with water or saline for 15 minutes and then stained with fluorescein. Referral to an ophthalmologist is recommended if there is any uptake of fluorescein.

Ingestion

Gastric lavage is not necessary following ingestion of ethanol. Activated charcoal is not of benefit. If there has been any vomiting, coughing or wheezing in a patient with altered mental status, then the patient will need to be assessed to determine if aspiration has occurred. Treatment is supportive. See below for management of systemic effects.

Systemic effects

Treatment is essentially supportive. If the patient is symptomatic, determination of a blood ethanol concentration should be considered. It is important to ensure the patient is adequately hydrated. Hypotension usually responds to intravenous fluids. In severe cases the electrolytes, blood gases and blood sugar should be monitored. Hypoglycaemia should be corrected with intravenous glucose/dextrose. Acidosis usually responds to correction of the hypoglycaemia and hypovolaemia but additional sodium bicarbonate may be required. Convulsions usually respond to the correction of hypoglycaemia, but diazepam may be used if required. Ventilate for respiratory depression. Haemodialysis should only be considered in life threatening cases (e.g., if the blood ethanol concentration is >5,000 mg/l or the arterial pH is less than 7), however, in practice this is rarely used.

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Diabetes 2

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