Here are symptoms to watch for

Approximately 10,000 poisonings every year are attributed to products that contain ethylene glycol or methanol, but the diagnosis is often missed in the ED, says Helen Zimmerman, MSN, CRNP, CEN, nurse practitioner at the Milton S. Hershey Medical Center in Hershey, PA.

"Making the diagnosis in the ED is a real problem," Zimmerman says. "It’s missed often because we’re not looking for it."

Here are signs and symptoms to watch for, according to Zimmerman:

• For ethylene glycol poisoning:

— nausea, vomiting, hyperventilation, hypertension, muscular tetany, convulsions, coma, and acute kidney failure;

— the presence of urinary crystals;

— initial symptoms which begin 30 minutes to 12 hours after ingestion and include inebriation, slurred speech, vomiting, and sleepiness.

— 4-12 hours after ingestion, an increase in metabolic acidosis, hyperventilation, hypertension, and tachycardia;

— 12-36 hours after ingestion, symptoms that might include progressive tachypnea, cyanosis, pulmonary edema, and cardiac failure leading to death.

• For methanol poisoning:

— blurred vision, accompanied by headache, dizziness, nausea, vomiting, and abdominal pain;

— visual complaints, ranging from blurred vision to spots before the eyes, to total loss of vision;

— diminished pupillary reflex, pupillary dilation, and optic disc hyperemia;

— initial central nervous system depression is weaker than that produced by ethanol, with a latent period of 10-30 hours. Symptoms include nausea, vomiting, weakness, abdominal pain, respiratory depression, and coma.