Overview
The Dangerous Delay
A person who drinks methanol may look only mildly intoxicated for many hours and then deteriorate with severe acidosis, visual loss, coma, or death.
A person who drinks methanol may look only mildly intoxicated for many hours and then deteriorate with severe acidosis, visual loss, coma, or death. The delay is deceptive rather than reassuring: methanol is converted gradually into formate, and formate—not methanol itself—causes most of the cellular injury. That mechanism determines the emergency sequence. With a plausible exposure, an unexplained high-anion-gap acidosis, an increased osmolal gap, or visual symptoms, contact the poison centre and begin ADH blockade immediately. Do not wait for a methanol concentration, and do not let a normal early examination or a late-normal osmolal gap close the case.