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Question: Tox

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At a New Year’s Eve party several glasses of champagne are left lying around the house. The family’s 2yo toddler proceeds to drink some of them. The parents sheepishly bring the somnolent child in to the ED, and the ethanol level is 120 mg/dL.

How quickly can you expect the patient’s ethanol level to decline?

pemsou5_wp • December 31, 2019

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  1. Kelly January 1, 2020 - 6:32 am Reply

    B) 15 mg/dL per hour
    Ethanol intoxication is seen in the PED in young children who accidentally ingest alcoholic beverages or household products with high alcohol concentrations (eg hand sanitizers, mouthwash), or who are purposely fed ethanol by caretakers for behavioral control, or by older preteens and teens who have purposely ingested alcohol. Peak serum levels are usually reached within 1 hour of ingestion, and levels decline at a rate of 10-25 mg/dL per hour. Ingestion of 0.4 mL/kg of 100% ethanol is expected to result in a toxic level of 50 mg/dL. Percent ethanol is proof divided by 2 (so 80 proof vodka is 40% ethanol). Beer is 4-8%, wine and champagne are 10-20%, and hard liquors are usually 40-60%. The volume of an average swallow for a small child is 5mL.

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