A 7-year old child is brought to the emergency room by the teacher. The child was in school and developed severe abdominal cramp, diarrhea and was very lethargic. The teacher is unable to provide much of a history but does state
that the child was adopted. In addition, he regularly missed school but the parents never provided an explanation. The child is too weak to respond. Quick exam reveals he is tachypneic and has altered mental status. His Bp is 90/75, Pulse 115, RR 30 and T 99.1. Quick blood work reveals metabolic acidosis. The ER physician then obtains urine and the microscopy is shown in the image below. While waiting for more studies, you will immediately start the patient on?
A. Methanol
B. Fomepizole
C. Activated charcoal
D, Nasogastric lavage