Attitudes and options of nurses in the care of methanol poisoned patients (theoretical thesis)

Methanol poisoning usually comes to the forefront of both professional and general public interest at times, when there is a larger outbreak, outside of these periods these cases appear sporadically. They occur in the whole world, in the developed countries as well as in the developing ones, independently of any restriction on the consumption of alcoholic beverages by the state. In Czech society this topic came to surface especially in 2012, when as a result of methanol intoxication the minimum of 50 people died and many more suffer permanent damage. The trickiness of methanol lies in the fact, that it is not possible to recognize it from ethanol in an alcoholic drink or in any other mixture. Most often it penetrates the organism by way of ingestion; it can also be absorbed through the skin or by inhalation. Methanol itself is not toxic; its metabolites (formaldehyde and formic acid) however present a problem. Typical symptoms include visual disturbances, deepening metabolic acidosis with an increased anion gap and damage to basal ganglia, particularly the putamen. The intoxication is further accompanied by a range of nonspecific symptoms such as stomach pain, nausea, vomiting, impairment of consciousness and cognitive functions. The gravity of the intoxication depends on the amount of ingested methanol and on the mixing ratio with ethanol. Therapy consists of administering specific antidotes ethanol or fomepizole, modifying of the internal environment, continuous or intermittent hemodialysis, if necessary and allowed by the patient's condition and in supportive treatment for maintaining the stability of vital functions. Nursing care has an unreplaceable role in treatment of these patients. Nurses come to contact with these patients in every sector of healthcare, they take part in admission, stabilization and monitoring of vital functions, they tend to the invasions as well as to maximal psychic and physical comfort of the patient. They take part in rehabilitation and also help patients returning into normal life. This thesis deals with the properties of methanol, its production and toxicity, it explores methanol intoxication, its symptoms and sequelae, diagnostics and therapy as well as nursing care in detail. It follows the role of nurses of all the sectors of health care in managing all the stages of the intoxication with emphasis on selected nursing activities in the intensive, standard or aftercare. The thesis concludes with 4 documented case studies. The aim of this thesis was to process the information collected on this topic into a complex and current overview of knowledge on methanol poisoning and the possibilities of dealing with it all of the phases of the poisoning including the aftercare of the patients who were affected. A summary of procedures and variations thereof was acquired on the theoretical basis of Czech and foreign sources such as books, renowned periodicals in paper or electronic form and by means of web sites of professional societies. The sum of knowledge this thesis provides can serve for teaching needsor continuing education of healthcare workers concerning diagnostics, therapy and management of the sequelae of this intoxication with special emphasis on the possibilities of nurse´s intervention in any of the phases of it, or to provide base for further research in this area