Emergency department hemodialysis in a case of severe ethylene glycol poisoning

A 36-year-old man with a history of depression presented to the emergency d epartment after ingesting approximately 3,000 mL of ethylene glycol antifre eze in a suicide attempt. The patient's ethylene glycol concentration, 1,88 9 mg/dL, was higher than any level previously documented in the medical lit erature. Although his course was complicated by nausea, emesis, lethargy, m etabolic acidosis, and kidney failure, the patient survived without persist ent kidney failure or other chronic problems. Sustained hemodialysis and et hanol infusion were instituted in the ED, on the basis of the patient's his tory, before laboratory confirmation of the ingestion was obtained.