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I thank Kobylianskii and colleagues for their case review in the management of a toxic alcohol poisoning but wonder if it could have been written to better reflect the realities of lab testing in non-tertiary centres. Most remote, rural, and community hospitals cannot access testing for methanol, ethylene glycol, isopropanol, and propylene glycol levels and instead of relying on these levels, we watch other indicators (closing anion and osmol gaps, normalizing VBG, improving creatinine) to determine whether or not to continue toxic alcohol protocols. Having information in the CMAJ apply to physicians in more hospitals would help to keep the journal relevant to readers.
Competing Interests: None declared.References
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