Currently, poisoning can occur with any food. But most often this phenomenon occurs with excessive or low-quality alcohol consumption. On the eve of the holidays, the problem becomes most urgent.

How to remove alcohol intoxication at home quickly and efficiently is of interest to many people. Today, there are several traditional and folk methods for alleviating the condition. But more important point is the prevention of such a condition.

Even in small doses alcohol has a harmful toxic effect on our central nervous system. In medicine, doctors distinguish between three stages of alcohol intoxication - mild, moderate and severe.

Today we will talk about what to do in case of alcohol poisoning at home, what assistance should be provided first of all in order to alleviate the condition of the injured person and prevent serious consequences for health and life.

What should not be done in case of alcohol poisoning, and in what cases is it necessary to see a doctor without wasting precious time on self-medication? Let's take a closer look at these issues, because this information is very important and can help, if necessary, provide first aid and save a person's life.

Stages of alcohol poisoning and their symptoms

For alcohol to work on the body, in fact, only 10-12 grams of ethanol is enough. This equals a glass of wine or a shot of vodka and is considered to be an average serving. It is after this dose that the breathalyzer is able to detect the release of alcohol vapors. The following stages of the development of alcohol intoxication with certain manifestations are conventionally distinguished:

1. 1-2 servings. After this volume, vasodilation is observed, a slight increase in heart rate, a feeling of warmth behind the breastbone, self-confidence and a decrease in concentration of attention appear. Indicators of alcohol vapors in exhaled air range from 0.3 to 1.0 ppm. Drinking alcohol on an empty stomach may cause slight speech impairment.
2. 5-6 servings. The balance is significantly disturbed, dizziness and delayed reaction appear. A person is capable of performing reckless actions. The ppm volume is 1.0-1.5. The state of intoxication is indicated by a wobbly gait and an alternation of psychomotor agitation with apathy.
3. 8-9 servings. After such an amount of alcoholic drink in the morning appears hangover syndrome... During drunkenness, speech, coordination of movements and vision are sharply disturbed. Breathalyzer results indicate 1.5-2.2 ppm.
4. 11-12 servings. The condition is quite serious. The body's response to alcohol consumption is uncontrolled vomiting, frequent urination, and diarrhea. There is no reaction to external stimuli, a person is not able to move independently, and sometimes even speak. The volume of alcohol in the exhaled air is 2.2-3.0 ‰.
5. 12 servings or more. Blood alcohol concentration exceeds everything allowable norms... As a result, a coma or death may develop. The body is not able to get rid of ethanol on its own, which affects work respiratory system and heart rate.

Attention!!!

For an adult with good health let's say taking one serving of alcohol per hour. It should be understood that this is a relatively safe amount of alcohol. The best option would be a complete absence of admission. strong drinks.

First aid - how you can help yourself

Life does not always give us pleasant surprises, very often the situation after festive feasts develops in such a way that the question arises: when did the poisoning occur in a person alcohol intoxication how to take off at home, urgently to save a life?

In case of severe alcohol intoxication, in the first place, a person should not be left unattended. He is constantly in certain danger, as he can fall and suffocate with vomit. In addition, in this state, there is often a sudden cessation of breathing and cardiac activity, a stroke, renal or hepatic colic develops.

Attention!!!

If persistent vomiting occurs, with impurities of bile or blood clots, you should immediately call ambulance... Such symptoms usually indicate the development of severe pathology.

Under the influence of alcohol, even the most calm and humble person is capable of sudden outbursts of aggression. Therefore, before carrying out first aid, you must try to explain to the victim the order of their actions. They will be as follows:

1. Free the person from dirty, oppressive, wet clothes and cover them warmly.
2. Do not try to take the victim to the shower room or constantly water him. strong tea, especially coffee. The caffeine contained in these drinks can intensify the phenomena of intoxication, in turn, this provokes the development of a heart attack and a sharp increase blood pressure.
3. Induce an artificial gag reflex. This is only allowed if the person is conscious. In a fainting or light-headed state, it is fraught with the entry of vomit into the respiratory tract.
4. During vomiting, give a drunk a half-sitting position, tilt your head forward and constantly hold it to prevent injury.
5. If the poisoned person is not able to sit, then during an emetic attack he must be put on his side and his head turned so that it hangs from the bed. In this position, the victim can fall, so it is also necessary to hold him.
6. To remove the remaining alcohol from the stomach, you can flush it out by drinking 2 glasses of salt water. Usually, a gag reflex occurs after this. It is recommended to flush until the water is clear.

Help with severe alcohol poisoning!

If the stomach is empty and vomiting does not stop, then the following should be done: wet the head cold water, apply ice from the back of the head, drink a little Rehydron solution, do not consume any food or other drinks.

Reducing alcohol intoxication - quick impact methods

First of all, it is necessary to reduce the amount of ethanol in the bloodstream. If this is not done, it will be difficult for the body to cope on its own. How to quickly remove alcohol intoxication and sober up without consequences? The following methods will help this:

1. Drinking plenty of fluids in combination with diuretics is an easy solution. It is worth remembering that such a remedy as Furosemide is prohibited. This can cause kidney problems.
2. A good option is the intake of aspirin, which actively neutralizes acetaldehyde, a substance produced by the breakdown of ethanol. It is this that causes the symptoms of poisoning.
3. To bind alcohol and the elements of its decay in the gastrointestinal tract, it is worth taking several tablets of activated carbon or Filtrum-Sti.
4. In severe cases, intravenous administration of certain drugs is required. It is not recommended to do this without special knowledge.
5. With strong intoxication good result observed with intramuscular injection of vitamin B6.
6. After clearing consciousness, you can drink a solution of niacin, phenamine, and corazole. A few drops of the product are added to half a glass of water. Even with strong intoxication, after a few minutes, thinking is normalized and lethargy disappears, and after 1-2 hours, complete sobering occurs.

A solution of glucose, ascorbic acid or Nicotinamide removes alcohol intoxication well. These funds can be counted with B vitamins.

When is an immediate ambulance call required?

The threat to life with alcohol intoxication can arise at any time. The danger is greatest in adolescence, in the elderly, as well as in people with concomitant somatic diseases.

In case of alcohol poisoning, when should you call an ambulance?

There are symptoms, in the presence of which it becomes clear that simple home methods are not capable of producing the desired effect. Therefore, when the following symptoms form, you need to call an ambulance:

• lack of consciousness and reaction to physical as well as noise stimuli;
• sharp pallor of the skin with pronounced cyanosis and the presence of cold clammy sweat;
• slowing down of the respiratory rhythm;
• the presence of pigmentation on the skin of an unusual shape;
• the development of seizures;
• abnormal wheezing or severe snoring;
• intermittent breathing lasting more than 10 seconds;
• entry of vomit into the respiratory tract.

What shouldn't be done?

Providing first aid to a person who is into alcohol poisoning should be approached with complete seriousness. There are a large number of myths according to which you can easily get rid of a serious condition. However, in practice, many of them remain ineffective or, on the contrary, can lead to unpleasant consequences.

Attention!

If present clear signs poisoning alcoholic beverages, do not take sleeping pills or sedatives. In most cases, this is fatal.

There is a difference between mild intoxication and real alcohol poisoning. Therefore, in severe cases, it is strictly forbidden to do the following:

1. Take a drunk man out to Fresh air and make him walk on the street. Due to a sharp violation of coordination of movements, serious injuries can occur when falling or colliding with various objects.
2. Leave a person unattended. In cases of drinking a large dose of alcohol, the concentration of ethanol in the bloodstream will increase as it is absorbed for a while, even if the person stopped drinking alcohol a few hours ago.
3. To give large doses strong coffee or black tea, and any drinks containing caffeine. This component, when mixed with alcohol, provokes dehydration of the whole body. Such an impact is fraught negative consequences in the structure of the brain.
4. Do not pour cold water on a drunk person. As a result of intoxication, the body temperature decreases, an additional cold effect can provoke hypothermia.

Non-traditional methods of influence for getting out of the state of alcoholic intoxication have been known for a long time. However, many of them are effective only in complex treatment with a certain amount of ethanol consumption. If there was an obvious poisoning, then such funds will only be an addition to the complex effect. The following are recommended for admission:

1. Diuretic teas. They are decoctions of parsley root, linden flowers, thyme or mint.
2. Saffron tincture. It is recommended to take it after a complete cleansing of the stomach. For preparation, one teaspoon of saffron powder is enough for a glass of boiling water.
3. Egg whites... For a single dose, you will need 2 raw chicken eggs... It is necessary to thoroughly loosen the proteins and drink in one gulp.
4. Honey water... It helps to eliminate malaise and speed up the sobering process. Preparing the solution is quite simple. Take 150 g natural honey and completely dissolve in a glass of water.
5. Apple vinegar. They give ammonia in the amount of 10 drops per glass of water (this remedy is quite dangerous and it is better not to use it), it is better to take apple cider vinegar in the amount of 1 teaspoon in half a glass of water. Solution apple cider vinegar must be drunk in small sips every 15 minutes.
6. Melissa and mint. When nausea does not go away even on an empty stomach, a decoction of lemon balm or mint will help to overcome this condition. It is recommended to drink it chilled, half a glass every 40-50 minutes.
7. Fresh Orange juice... It helps to effectively neutralize the toxins generated by the breakdown of ethanol.
8. Lemon and sugar. Half of the sour fruit you need to survive in a glass of water and add a spoonful of sugar.
9. Brine. This proven folk remedy, for several centuries, has been making it easier for people to feel after a meal. The most suitable is a brine from sauerkraut... However, it is worth noting that such treatment has only a symptomatic effect and is more suitable for hangover.

It's important to know!

Folk remedies that help with alcohol intoxication will be indispensable during the recovery period. They will help flush out toxins and strengthen the immune system.

Medicines for alcohol poisoning

Better that everyone medications the doctor prescribed. Of course, many are available over the counter without a prescription. Before use, be sure to read the instructions and pay attention to compatibility with other medicines. In case of alcohol poisoning, you will need several drugs with different effects.

Enterosorbents

They are prescribed immediately after emptying the stomach from the remnants of alcohol and food. Entosorbents, as it were, collect all the toxins and decomposition products of ethanol, which are subsequently excreted with feces. These include:

1. Enterosgel. Used for gastric lavage in a volume of 10-30 g to dissolve in warm water... After that Enterosgel is taken in pure form up to 50 g with a drink big amount water, repeated intake is allowed after 3 hours.
2. Polysorb MP. This drug must be drunk in the amount of one tablespoon, with a glass of water. At severe poisoning the frequency of admission increases to 5-6 times a day.
3. Smecta. The tool has not only a sorbing effect, but also an enveloping one. This is an additional plus for alcohol poisoning. A single dose is 1-2 sachets.

Adsorbents

Ethanol is able to be quickly absorbed into the bloodstream. Absorbent drugs simply do not have time to bind alcohol particles and prevent their spread. Therefore, they are considered as an addition to complex treatment and rehabilitation therapy. Adsorbents will be especially indispensable when various surrogates enter the body.

Lingosorb, Karbolen, Entegnin and Polyfenap have a fairly good effect. Rekitsen RD is considered a modern and highly effective drug today. It is used not only for poisoning, but also for alcohol withdrawal.

Symptomatic effects

To eliminate all results negative impact ethanol on the body, complex therapy is required. For this, drugs such as are suitable:

1. Biotredin. The drug has a fast action and does not accumulate in tissues. It helps to normalize metabolism, activate mental ability, relieve hangover symptoms and emotional stress.
2. Metadoxil. It contains a compound of magnesium and sodium. Allows you to accelerate the elimination of ethanol decay and quickly purify the blood. Available in tablets and injection solutions.
3. Yantavit. Is biologically active additive to food. The therapeutic effect is due to the effects of glucose and succinic acid. It is used to strengthen the body's defenses and restore energy metabolism.
4. Limontar. It has an antioxidant effect, enhances performance, appetite, neutralizes toxins, which ensures normal metabolism.
5. Alka-seltzer. This is a well-known drug that improves liver function, has an anti-inflammatory effect, relieves headaches and muscle pain, and also eliminates the manifestation of abstinence. This is due to the impact citric acid and sodium carbonate, which is contained in its composition.

Precautionary measures

To warn yourself against the consequences overuse strong drinks, certain actions should be performed. Unfortunately, they will not save you from surrogates, but they will reduce the hangover syndrome and help you recover faster. These rules include:

• before the feast, take 3-5 tablets of activated carbon;
• if possible, drink a glass of milk;
• vitamins that are taken a few days before certain events will help to alleviate the condition;
• during festivities, be sure to eat meat, fish dishes, and also potatoes;
• do not drink alcohol with carbonated drinks;
• try to take a break between drinking more often;
• drink in small doses;
• you should leave the table for fresh air and be outside for at least 10 minutes;
• stop drinking alcohol 3-4 hours before bedtime;
• drink more natural juices or compote;

You can eat immediately after the meal fresh fruits and vegetables (in a large number they should not be consumed while taking alcohol, as this will lead to a fermentation effect in the gastrointestinal tract and cause additional problems).

Conclusion

So that there is no need to remove alcohol intoxication on your own and at home, not tormented by such a serious condition as a hangover, you should completely abandon intoxicating drinks. This is the surest and most effective way.

It's important to know!

If only everyone who consumes alcohol was aware of the damage it brings to the body, how its internal organs and systems suffer, then it would certainly change the attitude towards this addiction.

Alcohol, even in small doses, has a toxic effect on the central nervous system. In medicine, there are three stages of alcohol intoxication - mild, moderate and severe.

What are the signs alcohol poisoning and how to remove alcohol intoxication at home? What medicines can be used to relieve hangover? What can not be done in case of poisoning, and in what cases do you need to see a doctor without spending time on self-medication? Let's look at these questions, but first, let's define what alcohol poisoning is.

What is alcohol intoxication

The term alcohol intoxication itself means poisoning of the body. ethyl alcohol... Normally, a small amount of ethanol is rendered harmless in the liver without consequences for the body. But when you consume an amount of alcohol that exceeds the detoxification capabilities of the liver, the poison enters the brain and causes disturbances in the higher nervous activity... Outwardly, this is manifested by a feeling of euphoria, clouding of consciousness, and impaired coordination.

With a severe degree of poisoning, a person loses sensitivity, reflexes weaken, and stunning sets in. In the extreme stage, cardiac arrest, cessation of breathing, and deep coma are possible. Such consequences arise when the concentration of ethyl alcohol in the blood is 3% or more. The lethal dose of alcohol is about 300 grams when translated into pure alcohol... If we consider the average lethal dose in terms of body weight, then it is 8 grams of ethanol per kg.

In everyday life, alcohol poisoning is called any changes accompanied by a deterioration in well-being due to drinking alcohol. They can appear immediately after taking a large dose (vomiting, loss of consciousness) or visit you the next morning - a hangover syndrome. In general, these conditions are treated in the same way, but there are some nuances. In the phase of acute poisoning, the effect of ethanol on the gastrointestinal tract and the brain is of great importance, and a hangover is largely provoked by the products of the partial decay of ethyl alcohol, in particular, acetaldehyde.

Poisoning by low-quality alcohol

Separately, it must be said about the poisoning of alcohol substitutes. According to statistics, this type of poisoning occupies a leading position in the list of all intoxications. Moreover, more than 90% of the victims die even before the hospitalization.

Alcohol surrogates are:

In case of poisoning with such products, intoxication is poorly expressed or does not occur at all, visual disturbances, convulsions, salivation, sweating, vomiting, pain in the abdomen and joints are often observed.

Intoxication with surrogates cannot be removed at home - you must immediately seek qualified medical help. Delay can cost your life. As first aid measures, induce vomiting, take enterosorbent and any enveloping agent. Further, hospitalization is required.

First aid for alcohol poisoning

What to do in case of alcohol poisoning at home? For this, a number of measures are taken to rid the body of ethyl alcohol and neutralize the products of its decay.

First aid for alcohol poisoning includes the following actions.

1. Remove the remnants of alcoholic beverages from the stomach. To do this, induce vomiting, then wash the stomach - drink 2-3 glasses of salted water, provoke vomiting again, and so on until practically pure water comes out of the stomach.
2. If you lose consciousness, you cannot provoke vomiting. Call an ambulance. While waiting for her arrival, lay the victim on one side, loosen his clothes, check the pulse and breathing. Turn your head, make sure that your tongue does not sink in, and vomit does not enter the respiratory tract. To bring the victim to his senses, give him a sniff of ammonia, rub his ears.

If alcohol poisoning does not pose a threat to life, then intoxication is removed independently at home.

Treatment of alcohol intoxication at home

Treatment of alcohol poisoning at home consists of the following actions:

Sometimes the poisoning is accompanied by bouts of vomiting. If you vomited once or twice, this is a natural reaction of the body to poison and there will be no harm from it, but only benefit, given the current state. But if the gagging does not go away after emptying the stomach, then you need to take action.

How to stop vomiting after alcohol poisoning?

1. Rinse your head with cold water or briefly apply ice to the back of your head.
2. Drink some water or Rehydron-type reconstitution solutions.
3. Do not eat or drink anything else until the stomach has calmed down.

If the measures taken do not work, then antiemetic drugs will help. Indomitable vomiting, the presence of bile in the vomit or blood impurities are grounds for immediate hospitalization.

Let's dwell on medicines, with the help of which alcohol poisoning is treated at home.

Enterosorbents

After emptying the stomach from the contents, you need to take enterosorbents. These drugs act in the intestines, capturing toxins and waste products on their surface, and removing them with feces. The following drugs have proven themselves well.

It must be remembered that all enterosorbents must be taken separately from drugs, otherwise the latter will lose their effectiveness. Between their receptions, it is necessary to observe a gap of at least one hour, and preferably two hours.

Restoring water balance

Vomiting dehydrates the body and flushes mineral salts out of it. In addition, alcohol is a powerful diuretic. In case of poisoning, you need to drink a lot of water, better than mineral or acidified lemon juice... Medicines belonging to the group of rehydrating agents help to cope with the imbalance that has arisen. They contain a balanced set of sodium, potassium, chlorides, and sometimes carbohydrates and help the body to cope with intoxication.

"Regidron" in case of alcohol intoxication can be taken orally in the amount of 10-17 ml of the ready-made solution per kg of body weight. One package of the drug is dissolved in one liter of water and stored in the refrigerator for no more than a day.

The analogues of "Regidron" are the preparations "Hydrovit" and "Citraglucosolan". You can also prepare a similar solution yourself: take 1/2 tsp for one liter of water. salt, 1/2 tsp. soda, 4 tbsp. l. Sahara.

With severe alcohol intoxication, a dropper is needed. Its composition is something like this:

• saline, or "Disol", or "Hemodez";
• 5 or 10% glucose solution;
• 5% solution of ascorbic acid.

If necessary, include vitamins (nicotinic acid, pyridoxine), magnesia, potassium chloride, panangin, heart drugs. The dropper volume is usually 400–500 ml. It should be installed by a medical professional, as well as to determine the composition of the solution for infusion - inept handling can cause harm to health.

Complete cleansing of the body from alcohol, possibly in the case of its excretion by the kidneys. For this, diuretics (diuretics) are used, the best and safest of which is considered plain water... You can also use recipes traditional medicine- drink herbal decoctions. They not only restore vitamin losses, but also supply the body with the antioxidants it needs.

Restoration of intestinal microflora

Alcohol and its decay products kill the beneficial intestinal microflora. After alcohol intoxication, activities are often disrupted gastrointestinal tract, constipation or diarrhea develops. The beneficial bacteria must be restored. This can be done by eating fermented milk and fermented foods or taking probiotics:

Eases the course of a hangover bowel movement. If constipation is noted after drinking alcohol, then an enema can be given - this will remove toxic products from the large intestine.

What not to do in case of alcohol poisoning

1. In no case should you combine the intake of alcohol and the diuretic "Furosemide", as this negatively affects the condition of the liver and kidneys.
2. Also, take aspirin with caution. It can be drunk only in a state of a hangover, but if the intoxication has not yet passed, then this medicine can cause various complications.
3. You can not use any sleeping pills, as they aggravate the depression of the central nervous system caused by alcohol.
4. The recommendation to go to the bathhouse and thereby get rid of a hangover is suitable only for people with Siberian health.

What to do with a hangover

How to treat a hangover in the morning after heavy drinking? The following measures are effective:

It is not worth experimenting with medicines, it is better to resort to the help of special tablets for alcohol poisoning:

• Biotredin;
• "Limontar";
• "Metadoxil";
• Alka-Seltzer.

Folk remedies for a hangover

If there are no pills at hand, then you can use folk remedies used for alcohol poisoning. In addition to the already mentioned pickles from a hangover, the following remedies help:

Good for hangovers cold and hot shower... Start with hot water, then switch to pleasantly cold, alternating for 30-60 seconds several times, gradually increasing the temperature difference. Such a contrast will allow the skin to get rid of toxins and toxins, improve the functioning of the heart and blood vessels.

In conclusion, we note that preventing a hangover is much easier and more enjoyable than treating it. To do this, do not abuse the amount of alcohol, have a good snack with foods containing starch and pectins (potatoes, bananas), and take in preventive purposes one of the recommended enterosorbents.

A question for narcologists about what to do when alcoholic intoxication, often asked by the spouses of addicted people. Unawareness of the problem, degradation of the alcoholic's personality under the influence of toxic ethanol surrogates does not allow turning to a specialist due to the denial of the disease.

The classic remedies used by a person with an addiction to alcoholic beverages are cerucal (for vomiting), Activated carbon(to cleanse the intestines). With the accumulation of toxic metabolites, such drugs cannot get rid of addiction. Pathology develops under the influence of poisons internal organs, irreversible changes in the liver, pancreas, and kidneys gradually develop. Failure of organs becomes the cause of death. Alcoholics die young!

Alcohol poisoning: symptoms and syndromes

The problem of the high cost of alcoholic beverages is aggravated. In the absence of funds, replacement of the next dose of alcohol is required. To fill the deficit, alcohol-containing products are used: colognes, perfumes, medicinal tinctures, lotions. When using alkaline polish, alcohol varnishes, BF adhesives, life-threatening poisoning occurs.

The lethal dose of ethyl alcohol is 300-400 mg. This concentration is achieved by consuming 2-3 bottles of vodka per day, with a break after 1-2 hours.

A decrease in the body's resistance in chronic alcoholics is accompanied by a certain degree of internal organ failure. Against this background, mortality increases not from alcohol surrogates, but from an exacerbation of secondary diseases.

The main symptoms of alcohol poisoning:

• Mild - nausea, vomiting, intestinal disorders;
• Moderate - disruption to work of cardio-vascular system, change in coordination, gait;
• Severe - alcoholic coma with loss of pain, temperature sensitivity.

Due to the high adaptation of the body to alcoholic surrogates the coma of an alcoholic is not fatal. After a few hours, the condition is restored.

The danger is represented by severe injuries, bedsores, gangrene of the extremities with a prolonged immobility of a person. Violation of local blood supply, hypothermia occurs at an ambient temperature of about 12 degrees Celsius. It gradually decreases to 31-32 degrees. Reducing the heart rate to 30-60 beats per minute. Respiratory depression - up to 8 breaths per minute. These conditions lead to death directly from respiratory failure (on the first day) or from dangerous complications in the future (pneumonia, gangrene of the lung).

I. Gastric lavage through a tube (3-5 liters of water 37 °). P. In acute respiratory failure:

1. Restoration of airway patency (suction of vomit).

2. Ventilation with 100% oxygen.

3. Naloxone (0.4 mg in 1 ml), 2-4 ml IV slowly ..

Antidotes: sodium thiosulfate 20% - 20 ml i.v., unitiol 5% -10 ml i.v.

For endotoxic shock: dopamine 200 mg per 5% glucose solution 500 ml i.v., disol, acesol 500 ml i.v., HES 6% - 250 ml i.v., HAES 250 ml i.v.

Fight Acidosis:

Sodium bicarbonate 4% - up to 1000 ml / in under the control of blood pH.

Ascorbic acid 5% -10 ml IV.

Vi. With encephalopathy:

1. Thiamine 5% - 2 ml IV.

Magnesia sulfate 25% - 5 ml IV slowly.

Lasix 20 mg IV.

Vii. With hypoglycemia: glucose 40% - 40 ml IV.

VIII. With convulsions: Relanium 0.5% - 2 ml IV.

Pulmonology

Provide emergency care for an attack of bronchial asthma.

Algorithm for providing emergency care for an attack of bronchial asthma.

Inhalation (β2 - short-acting agonists through a metered-dose aerosol inhaler with a spacer of salbutamol, beroteca or berodual 2 breaths, preferably through a nebulizer (2 ml / 2.5 mg salbutamol, beroteca 10 drops or berodual 20 drops) .If there is no effect, repeat inhalations up to 3 x times within an hour.

Prednisolone 30-60 mg (or dexamethasone 4-8 mg) IV.

Solution of aminophylline 2.4% - 10 ml IV.

4. If the attack is not stopped - hospitalization

Treatment of patients with exacerbation of bronchial asthma.

Initial therapy

Oxygen inhalation until SaO 2 is ≥ 90%.

Continuous inhalation of a fast-acting β 2 -agonist for 1 hour.

In the absence of an immediate response, or if the patient has recently taken oral corticosteroids, or if there is a severe asthma attack, systemic corticosteroids.

With an exacerbation, sedative therapy is contraindicated.

Treating a severe attack of suffocation

Oxygen.

Inhaled β 2 -agonist and inhaled anticholinergic drug.

Systemic GCS.

Intravenous administration of magnesium sulfate solution.

A good response to treatment within 1-2 hours is home treatment.

Unsatisfactory response to treatment within 1-2 hours - transfer to the intensive care unit / intensive care unit

Oxygen.

Inhaled β2 agonist + inhaled anticholinergic drug.

Intravenous GCS.

Intravenous administration of β2-agonists is possible.

Intravenous administration of theophylline is possible.

Intubation and mechanical ventilation are possible.

Providing emergency care for asthmatic conditions

Oxygen therapy

Nebulizer therapy:

1. β2-agonists (Berotec 10 drops or salbutamol 2.5 mg or Berodual 20 drops) through a nebulizer every 20 minutes for the first hour, then after 1 hour, then after 4 hours.

2. Pulmicort 1-2 mg x 2 times a day through a nebulizer.

Introductions of systemic corticosteroids: Prednisolone 60mg x 2 times intravenous drip.

Infusion therapy (up to 2 l) under diuresis control:

Oxygen therapy

Nebulizer therapy:

β2-agonists (Berotec 10 drops or salbutamol 2.5 mg or Berodual 20 drops) through a nebulizer every 20 minutes for the first hour, then after 1 hour, then after 4 hours.

Pulmicort 2-4mg x 2 times a day.

Infusion therapy (2-2.5 liters) under the control of diuresis:

Introductions of systemic corticosteroids: Prednisolone 60mg x 3-4 times a day intravenous drip.

Eufillin 2.4% -10.0 x 2 times intravenous drip.

Heparin 10 thousand x 2 times IV drip.

With an increase in signs of hypoxia (precoma), cordiamine 2.0 i.v., magnesium sulfate 25% -10.0 i.v.

Stage III

Ventilation with sanitation of the bronchial tree through an endotracheal tube. Nebulizer therapy in the same volume through the ventilator circuit.

Increasing the GCS dose by half.

Continuation of the administration of bronchodilators, heparin, cordiamine, cardiac glycosides according to indications. Correction of metabolic disorders. (solution of sodium bicarbonate 200 ml, potassium preparations, etc.)

In case of a poor response to therapy (decrease in PSV) in stages I and II, SGKS is added at a dose of 30 mg for prednisolone.

With steroid addiction bronchial asthma the maintenance dose of corticosteroids is immediately doubled.

In the absence of a nebulizer, β2-agonists are prescribed 4 inhalations through an AIM with a spacer 3 times within 1 hour, then 2 inhalations after 1 hour, and then after 4 hours. Prednisolone intravenous drip and intramuscular injection: in the 1st century. - 240-360 mg / day, in the II st. - 360-720mg / day, in the III st. - up to 1000 mg / day or more.

Quincke's edema and emergency care

Algorithm for providing emergency care for angioedema.

Antihistamines (Suprastin solution 2.0 ml IV, Tavegil solution 2.0 ml IV).

Parenteral systemic glucocorticosteroids (prednisone 90-120 mg IV or desamethasone 16-24 mg IV).

Lasix 4.0 ml / m

With an increase in suffocation - tracheostomy.

Algorithm for providing emergency care for anaphylactic shock.

Stop administering the medication immediately.

Lay the patient down (head below the legs), turn his head to the side, extend the lower jaw, remove removable dentures.

Apply a venous tourniquet to the limb above the injection site for 25 minutes (loosen the tourniquet for 1-2 minutes every 10 minutes).

To chop the injection site at 5-6 points with 0.1% adrenaline solution - 0.3-0.5 ml with 4-5 ml of 0.9% sodium chloride solution.

Apply ice or a heating pad with cold water to the injection site for 15 minutes.

Into a limb free from a tourniquet, inject 0.1% adrenaline solution 0.3-0.5 ml / m (if necessary, repeat the injections after 5-20 minutes, up to a total dose of 2 ml).

Enter prednisolone solution 90-120 mg (or dexamethasone 8-16 mg) intravenously in 20.0 ml of 0.9% sodium chloride solution.

Provide access to the vein, start a bolus injection of fluid (saline for adults - 1 liter, for children at the rate of 20 ml / kg of body weight).

With blood pressure more than 90 mm Hg. - Suprastin 2% - 2 ml / m or tavegil 0.1% - 2 ml / m. In case of prevalence in the clinical picture:

Violation of hemodynamics. Epinephrine 0.1% - dilute 1 ml in 100 ml of saline and inject i / v as slowly as possible (or mezaton 1% - 1.0 ml or dopamine 400 mg (2 ampoules) i / v drip on glucose solution 5 % -500 ml) under the control of heart rate and blood pressure. Prednisolone 60 mg IV drip or dexamethasone 8 mg per 200.0 ml of 0.9% sodium chloride solution.

Asthmatic Syndrome. Euphyllin 2.4% -10.0 i.v. per 20.0 ml - 0.9% sodium chloride solution. Prednisolone 60 mg IV drip or dexamethasone 8 mg per 200.0 ml of 0.9% sodium chloride solution. Inhalation of p2 - short-acting agonists, preferably through a nebulizer (2 ml / 2.5 mg salbutamol or berodual)

3. Quincke's edema. Lasix 1% - 2.0 ml IV. Prednisolone 60-150 mg IV.

With swelling of the larynx and an increase in suffocation - a tracheostomy. If after 20-30 minutes the condition does not improve:

Re-enter solution of adrenaline 0.1% - 0.5 ml / m.

Prednisolone 60 mg (or dexamethasone 8 mg) intravenously drip in 200 ml of 0.9% sodium chloride solution. The daily dose of prednisolone is up to 1000 mg or more.

Norepinephrine 0.2% - 0.2-1 ml or adrenaline 0.1% -1 ml intravenous drip in 500 ml of 0.9% sodium chloride solution. If the condition does not improve, further management in the intensive care unit: Mouth-to-mouth ventilation, then intubation with 100% oxygen and IV infusion therapy begins (epinephrine, glucocorticosteroids, plasma-substituting solutions, etc.).

With a fulminant form of shock - pulmonary cardiac resuscitation.

Alcohol- flavored alcoholic beverages based on purified ethyl alcohol (wine, cognac, water, champagne, whiskey, liqueurs, etc.). Alcohol surrogates- defective substitutes for ethanol, which are used as alcoholic drinks, are true (hydrolytic and technical alcohols, cologne, etc.) and false (methanol, ethylene glycol).

Poisoning with alcohol and its substitutes is the most common household poisoning, lethal dose 96 ° ethanol ranges from 4 to 12 g / kg of body weight, alcoholic coma occurs when the alcohol concentration in the blood is 3 g / l and above, death - at 5-6 g / l and above.

Ethanol poisoning clinic:

- intoxication of varying degrees, turning into depression of consciousness up to coma

- at first, euphoria, emotional lability, violations of social norms of decency in behavior, aggressiveness, followed by deep stunning, indifference are characteristic

- violations of the motor sphere: from a wobbly gait to the inability to independently stand upright

- the characteristic smell of alcohol emanating from the patient

- hyperemia of cold, moist skin of the face, injection of the sclera, constricted pupils, horizontal nystagmus

- hypersalivation, sweating, vomiting with possible aspiration-obstructive breathing disorders or mechanical asphyxia (with aspiration of vomit or retraction of the tongue)

- involuntary urination and defecation

- frequent, weak pulse, collaptoid state

- a high level of ethanol in the blood (the diagnosis of alcohol intoxication is legitimate when the alcohol concentration in the blood is above 0.5 ppm)

Alcoholic coma should be differentiated from TBI, poisoning with alcohol substitutes or hypnotics, tranquilizers, from diabetic coma; since these conditions can be combined, it is imperative to examine the patient's blood for the content of glucose, barbiturates and other sedative drugs in it, to make an X-ray of the skull in two projections.

Emergency aid for alcohol poisoning:

1. All patients with severe intoxication and poisoning with alcohol or its surrogates must be hospitalized (transportation in a lateral position with a lowered headboard to prevent aspiration)

2. Gastric lavage through a tube to clean wash water (in the case of deep coma - only after tracheal intubation) followed by the introduction of enterosorbents (activated carbon, polyphepan, etc.) and saline laxatives in the form of an aqueous suspension through a tube or oral

3. Forced diuresis: intravenous infusion of crystalloid solutions (isotonic sodium chloride solution, 5% glucose) + furosemide / lasix 40 mg intravenous

4. Toilet of the oral cavity, taking the tongue onto the tongue holder, suction of mucus from the pharyngeal cavity, in the absence of pharyngeal reflexes, respiratory disorders of central origin - intubation and transfer to mechanical ventilation.

5. Infusion of 40% glucose solution 40 ml with 15 UNITS of insulin IV jet

6. Vitamins B1 5 ml / m and B6 2 ml / m (antidotes for ethanol), nicotinic acid 5% solution 1 ml s / c

7. Alkalinization of urine, correction of metabolic acidosis of blood: 4% solution of sodium bicarbonate up to 1000 ml intravenous drip

8. Symptomatic therapy, depending on the complications that arise (relief of seizures with sodium oxybutyrate, piracetam, etc.)