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Windshield washer fluid

 

Windshield washer fluid is a brightly colored liquid made of methanol, a poisonous alcohol. Sometimes small amounts of other toxic alcohols such as ethylene glycol are added to the mixture.

Some young children may mistake the fluid for juice, which can lead to accidental poisoning. Even small amounts can cause significant damage. This article discusses poisoning from swallowing windshield washer fluid.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Methanol (methyl alcohol, wood alcohol)

Where Found

 

This poison is found in:

  • Windshield washer fluid (used to clean automobile windows)

 

Symptoms

 

Symptoms of windshield washer fluid poisoning affect many different body systems, including:

Airway and lungs:

  • Breathing difficulty
  • No breathing

Eyes

  • Blindness , complete or partial, sometimes described as "snow blindness"
  • Blurred vision
  • Dilation (widening) of the pupils

Heart and blood

  • Low blood pressure

Nervous system

  • Agitated behavior
  • Coma
  • Confusion
  • Difficulty walking
  • Dizziness
  • Headache
  • Seizures

Skin and nails

  • Bluish-colored lips and fingernails

Stomach and intestines

  • Abdominal pain (severe)
  • Diarrhea
  • Nausea
  • Vomiting, sometimes bloody

Other

  • Fatigue
  • Leg cramps
  • Weakness
  • Yellow skin (jaundice)

 

Home Care

 

Seek immediate medical help. DO NOT make a person throw up unless told to do so by Poison Control or a health care professional.

 

Before Calling Emergency

 

The following information is helpful for emergency assistance:

  • Person's age, weight, and condition (for example, is the person awake or alert?)
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed

However, DO NOT delay calling for help if this information is not immediately available.

 

Poison Control

 

Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. You can call 24 hours a day, 7 days a week.

 

What to Expect at the Emergency Room

 

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:

  • Activated charcoal
  • Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
  • Blood and urine tests
  • Chest x-ray
  • CT (computerized tomography, or advanced imaging) scan
  • EKG (electrocardiogram, or heart tracing)
  • Fluids through a vein (intravenous or IV)
  • Medicine to treat symptoms, including antidotes to reverse the effect of the poison (fomepizole or ethanol)
  • Tube through the nose to remove the remaining poison if the person is seen within 60 minutes of swallowing it

Because rapid removal of methanol is a key to treatment and survival, a kidney machine (renal dialysis) will likely be needed.

 

Outlook (Prognosis)

 

Methanol, the main ingredient in windshield washing fluid, is extremely poisonous. As little as 2 tablespoons (30 milliliters) can be deadly to a child. About 2 to 8 ounces (60 to 240 milliliters) can be deadly for an adult. Blindness is common and often permanent despite medical care.

The ultimate outcome depends on how much poison was swallowed and how soon treatment was received.

Although many windshield washer fluids are a watered-down form of methanol, they can still be dangerous if swallowed.

 

 

References

Barceloux DC, Bond GR, Krenzelok EP, et al. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol . 2002;40(4):415-46. PMID: 12216995 www.ncbi.nlm.nih.gov/pubmed/12216995 .

Goldfrank LR, ed. Goldfrank's Toxicologic Emergencies . 8th ed. New York, NY: McGraw Hill; 2006.

Michael JB. Deadly pediatric poisons: nine common agents that kill at low doses. Emerg Med Clin North Am . 2004;22(4):1019-50. PMID: 15474780 www.ncbi.nlm.nih.gov/pubmed/15474780 .

White SR. Toxic alcohols. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 155.

 

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              Review Date: 1/25/2015

              Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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