We present a series of patients with profound metabolic acidosis admitted to the Role 3 Medical Treatment Facility, Camp Bastion, Afghanistan, in 2012. A police service breath alcohol analyser, calculation of the osmolar gap and urine microscopy assisted in diagnosing methanol poisoning. The challenge of diagnosing and managing toxic alcohol poisoning in this resource-limited setting is discussed. We believe this is the first description of using a breath alcohol analyser to assist a diagnosis of methanol poisoning.

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