Observation and patient disposition after methanol and ethylene glycol poisonings

Admit all patients with suspected methanol or ethylene glycol poisoning to an intensive care unit for ongoing assessment and management of toxicity.

Discharge patients treated with antidotal therapy when:

• they are clinically well
• metabolic acidosis and end-organ dysfunction have resolved
• osmolar gap and lactate gap have normalised
• serum methanol or ethylene glycol concentration (if available) is less than 20 mg/dL (6.24 mmol/L for methanol, 3.23 mmol/L for ethylene glycol).

Patients not treated with antidotal therapy can be discharged after at least 6 hours of observation if they are asymptomatic and have a normal acid-base status.

Sedative agents can continue to cause significant cognitive impairment after discharge. Advise patients not to drive or operate machinery for at least 3 days.