Liverpool Hospital Emergency Department


  • Ethylene Glycol (Anti-Freeze)
  • Methanol  


  • IV formulation:
    • 96% to 100% Dehydrated Ethanol 5-10mL Ampoule (Must be diluted  prior to administration) – dilute to 10% ethanol.
    • Note: Treat ALL dehydrated ethanol IV ampoules as 100%
    • Dilution: Dilute 100mL of Dehydrated Ethanol with 900mL of Glucose 5% to  create 10% Ethanol in 1L IV 
  • PO/NG formulation:
    • White spirit e.g. Vodka 40%  

Dosage and Administration 

  • Intravenous 
    • Loading: 6mL/Kg IV or NG (Table 1) over 60 minutes
    • Maintenance: 50-100mL /Hour IV or NG to maintain a plasma ethanol level  of 22 mmol/L – 44mmol/L. Serum ethanol levels must be performed hourly  to ensure steady state.
  • If on dialysis the maintenance dose must be double

  • Oral 
    • Loading: 40% vodka – 3 measures of 40mls of vodka (1.8ml/kg 43%)
    • Maintenance: 40ml / hr via NGT (80ml/hr if on dialysis) to maintain ethanol  level of 22-44mmol/L. (0.2-0.4ml/kg/hr) 

Side Effects 

  • Intoxication
  • Local phlebitis from IV ethanol
  • Hypoglycaemia Cardiac Failure
  • Heart Block
  • Myocardial Necrosis (Excessive)
  • Ventricular Fibrillation/ Tachycardia
  • Pain
  • Paraesthesia 

Pit Falls 

  • Can be difficult to titrate to blood alcohol levels
  • Dialysis will be required and planned for
  • Consider supportive care of airway management given the risk of vomiting and  gastroparesis
  • Continue until methanol or ethylene glycol level is <6.7mmol/l or 20mg/dL