May see:
Anion gap acidosis
Will not be present immediately after exposure (only metabolite causes acidosis)
Hypocalcemia secondary to formation of calcium oxalate crystals
Renal failure
Glucose - may be low in setting of decreased caloric intake
Will not be present immediately after exposure (only metabolite causes acidosis)
Osm gap:
Calculated serum osm - measured serum osm
Calculated serum osm = 2Na + BUN/2.8 + glucose/18 + ethanol/4.2)
Normal < 10
>50 highly suggestive of toxic alcohol poisoning
Note: Cannot rule out toxic ingestion with a "normal" osmol gap
Only parent alcohol is osmotically active
Delayed presentation may mean that much of it is already metabolized
May be useful however even if elevated, patients can still have ingested a toxic alcohol
Hematuria, proteinuria, pyuria
Calcium oxalate crystals (late finding; only seen in 50%)
Urinary fluorescence (may be seen 6 hours after ingestion), but lacks sensitivity and specificity
Useful to assess for signs of rhabdomyolysis especially if the patient was found laying down
Needed to assess degree of acidosis. An ABG is not necessary since pH can be approximated with a clinical degree via a VBG
QT prolongation ~ hypocalcemia
Useful to discern the cause of the anion gap as well as assess for other toxic ingestion
Ethylene glycol toxicity
Absinthe
Methane toxicity
Barbiturates
Hydrazine toxicity
Benzodiazepines
Methanol toxicity
Flunitrazepam 