Methanol is used as an industrial solvent and is an ingredient of methylated spirits. It is often ingested for self-harm or as a substitute for alcohol. It can form in home-distilled crude alcohol due to incomplete conversion to ethanol.
A dose >1 g/kg is potentially lethal: it is transformed into toxic metabolites and causes profound acidosis.
- Initial inebriation (as in alcohol assumption)
- Latent asymptomatic period of 12-24 hours
- Headache, dizziness, nausea, vomiting, visual disturbances, CNS depression and respiratory failure
- Toxic metabolites may cause severe acidosis and retinal/ optic nerve damage
- Gastric aspiration and lavage
- Only use if done within 2 hours of ingestion (it has a very rapid absorption)
- Charcoal is NOT USEFUL
- Give 1.5-2 ml/kg of oral alcohol 40% (e.g. waragi, whisky, brandy) in 180 ml of water as loading dose, oral or via NGT
- Maintenance dose: 0.3 ml/kg/hour
- Sodium bicarbonate 50-100 ml IV over 30-45 minutes
- Check for and correct hypoglycaemia