Antifreeze is a common automotive product designed to prevent vehicle engines from freezing or overheating. If ingested, its chemicals can cause severe, life-threatening harm. Swallowing antifreeze is a medical emergency requiring immediate professional attention due to its highly toxic nature.
The Toxic Components of Antifreeze
The primary toxic ingredient in most antifreeze is ethylene glycol. The serious danger arises when it is metabolized within the body. The liver processes ethylene glycol into several highly toxic compounds, including glycoaldehyde, glycolic acid, glyoxylic acid, and oxalic acid. These byproducts are responsible for severe systemic damage.
These toxic metabolites disrupt normal cellular functions, leading to metabolic acidosis where the body’s pH balance becomes dangerously acidic. Oxalic acid combines with calcium to form calcium oxalate crystals. These crystals deposit in various organs, contributing to organ damage, especially in the kidneys. Some antifreeze products may contain propylene glycol, which is less toxic than ethylene glycol but still requires medical evaluation if ingested.
Stages of Antifreeze Poisoning
The effects of antifreeze poisoning unfold in distinct stages, reflecting progressive damage caused by its metabolites. The initial neurological (CNS) stage begins within 30 minutes to 12 hours after ingestion. Individuals may experience symptoms similar to alcohol intoxication, such as dizziness, nausea, vomiting, and confusion. As poisoning progresses, more severe neurological effects can develop, including seizures and unconsciousness, potentially leading to a coma.
The second, cardiopulmonary stage generally occurs between 12 and 24 hours post-ingestion. Accumulated toxic acids significantly affect the heart and lungs. Symptoms include rapid breathing, an increased heart rate, and low blood pressure. Fluid accumulation in the lungs (pulmonary edema) may also occur, making breathing difficult and potentially leading to heart failure.
The final, renal stage typically manifests 24 to 72 hours after exposure. This stage is characterized by acute kidney injury as calcium oxalate crystals deposit within the kidney tubules, obstructing their function. Symptoms include flank pain, a decrease in urine output, and widespread swelling due to fluid retention. If not promptly treated, kidney damage can become permanent, necessitating long-term dialysis or kidney transplantation.
Immediate Steps After Ingestion
If someone has swallowed antifreeze, immediate action is crucial. Call emergency medical services (911) or your local poison control center immediately. Provide as much information as possible, including the type of antifreeze ingested, the approximate amount, and the time of ingestion. It is also helpful to know the age and weight of the person affected.
Do not induce vomiting, as this can cause further complications or aspiration of the toxic substance into the lungs. While awaiting emergency personnel, keep the affected individual calm and comfortable. Gathering the antifreeze container can be beneficial, providing medical professionals with specific information about the chemicals involved. Rapid transportation to a hospital is essential, as treatment effectiveness relies on how quickly medical intervention begins after ingestion.
Medical Treatment and Recovery
At a medical facility, antifreeze poisoning diagnosis involves several assessments. Blood tests measure ethylene glycol levels, assess the degree of metabolic acidosis, and evaluate kidney function. These tests help confirm the poisoning and determine its severity, guiding treatment. Early and accurate diagnosis is important for effective management.
Medical treatment focuses on preventing ethylene glycol metabolism into its toxic byproducts and removing the compound and its metabolites. Antidotes such as fomepizole or ethanol are administered intravenously to block the enzyme alcohol dehydrogenase, which converts ethylene glycol into its harmful forms. In severe cases, or when kidney failure has begun, hemodialysis is often performed.
This procedure filters the blood, removing ethylene glycol and its toxic metabolites. Supportive care, including intravenous fluids and management of metabolic acidosis, is also provided to stabilize the patient. Prognosis depends on the amount ingested and the speed of medical intervention. Early and aggressive treatment can lead to a full recovery, but significant delays can result in permanent organ damage, particularly to the kidneys, potentially requiring lifelong medical management.