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Ethylene Glycol (EG) intoxicated patient arrives in emergency department Loading dose of Fomepizole administered, serum EG levels sent to lab. Is serum EG level above medical treatment criteria? NO Admission to regular medical floor Fomepizole only therapy initiated YES   Admission to critical care bed   Termination of therapy Q12 hour Fomepizole adminsitration until serum EG level <=20mg/dL   Hemodialysis (HD) and Fomepizole combination therapy initiated 8-12 hour HD run until serum EG levels <=20mg/dL with q4 hour Fomepizole during treatment course