Louise MORRELL, MD, RESIDENT IN MEDICINE, JEWISH Hospital at Washington University, St Louis: A 23-year-old man presented to the emergency room of an outside hospital 30 minutes after ingesting 400 to 800 mL of an ethylene glycol–based brake fluid. The patient was agitated and incoherent and had a history of suicide attempts. Laboratory values included the following: plasma sodium, 138 mEq/L (138 mmol/L); potassium, 2.7 mEq/L (2.7 mmol/L); chloride, 103 mEq/L (103 mmol/L); bicarbonate, 14 mEq/L (14 mmol/L); creatinine, 1.0 mg/dL (88.4 μmol/L); arterial oxygen pressure, 105 mm Hg (room air); arterial carbon dioxide pressure, 35 mm Hg; and pH 7.25. The calculated anion gap was 21 mEq/L. The white blood cell count was 16 000/mm3 (16 ×109/L) with a hemoglobin level of 15 g/dL (150 g/L) and a hematocrit of 35% (0.35).
The patient underwent gastric lavage with normal saline and received intravenous sodium bicarbonate (50
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 27
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.