Antifreeze poisoning

The poisonous ingredients in antifreeze are:

• Ethylene glycol
• Methanol
• Propylene glycol

The above ingredients are found in various antifreezes. They may also be used in other products.

Below are symptoms of antifreeze poisoning in different parts of the body.

AIRWAYS AND LUNGS

• Rapid breathing
• No breathing

BLADDER AND KIDNEYS

• Blood in urine
• No urine output or decreased urine output

EYES, EARS, NOSE, AND THROAT

• Blurred vision
• Blindness

HEART AND BLOOD

• Rapid heartbeat
• Low blood pressure

MUSCLES AND JOINTS

• Leg cramps

NERVOUS SYSTEM

• Coma
• Convulsions
• Dizziness
• Fatigue
• Headache
• Slurred speech
• Stupor (lack of alertness)
• Unconsciousness
• Unsteady walk
• Weakness

SKIN

• Blue lips and fingernails

STOMACH AND GASTROINTESTINAL TRACT

• Nausea and vomiting

Seek medical help right away. DO NOT make a person throw up unless poison control or a health care provider tells you to.

Use standard first aid and CPR for signs of shock or no heartbeat (cardiac arrest). Call your local poison control center or 911 for more help.

Have this information ready:

• Person's age, weight, and condition
• Name of product (as well as the ingredients, if known)
• Time it was swallowed
• Amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The person may receive:

• Blood and urine tests
• Breathing support, including oxygen, tube through the mouth into the throat, and breathing machine
• Chest x-ray
• CT scan of the head (computed tomography)
• ECG (electrocardiogram or heart tracing)
• Intravenous fluids (through a vein)
• Medicines to reverse the effects of the poison
• Tube placed down the nose and into the stomach (sometimes)

Dialysis (kidney machine) treatment may be needed during recovery. This need may be permanent if kidney damage is severe.

For ethylene glycol: Death may occur within the first 24 hours. If the patient survives, there may be little or no urine output for several weeks before the kidneys recover. Kidney damage may be permanent. Any brain damage that occurs also may be permanent.

For methanol: Methanol is extremely toxic. As little as 2 tablespoons (1 ounce or 30 milliliters) can kill a child, and 4 to 16 tablespoons (2 to 8 ounces or 60 to 240 milliliters) can be deadly for an adult. The outcome depends on how much was swallowed and how soon appropriate care was given. Vision loss or blindness may be permanent

Permanent damage to the nervous system may occur. This can cause blindness, decreased mental functioning, and a condition similar to Parkinson disease.

Keep all chemicals, cleaners, and industrial products in their original containers and marked as poison, and out of the reach of children. This will reduce the risk for poisoning and overdose.

Engine coolant poisoning

Nelson ME. Toxic alcohols. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 136.

Thomas SHL. Poisoning. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 10.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.