Alcohol   - alcoholic beverages based on purified ethyl alcohol (wine, cognac, water, champagne, whiskey, liqueurs, etc.). Alcohol surrogates   - Defective ethanol substitutes that are used as alcoholic beverages are true (hydrolysis and technical alcohols, cologne, etc.) and false (methanol, ethylene glycol).

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

Clinic of ethanol poisoning:

Intoxication of varying degrees, turning into oppression of consciousness up to a coma

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

Disorders of the motor sphere: from a shaky gait to the inability to stand upright on one's own

The characteristic smell of alcohol emanating from the patient

Hyperemia of cold, wet skin of the face, injection of the sclera, narrowed pupils, horizontal nystagmus

Hypersalivation, sweating, vomiting with possible aspiration-obstructive respiratory failure or mechanical asphyxia (with aspiration of vomit or retraction of the tongue)

Involuntary urination and bowel movements

Frequent, weak pulse, collapoid state

High level of ethanol in the blood (the diagnosis of alcohol intoxication is valid when the concentration of alcohol in the blood is above 0.5 ppm)

Alcoholic coma should be differentiated from TBI, poisoning with alcohol substitutes or sleeping pills, tranquilizers, from a diabetic coma; because 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, and take an X-ray of the skull in two projections.

Emergency care for alcohol poisoning:

1. All patients with severe intoxication and poisoning with alcohol or its substitutes must be hospitalized (transportation in the position on the side with the headboard down to prevent aspiration)

2. Gastric lavage through the probe to clean washings (in the case of deep coma - only after tracheal intubation) followed by the administration of enterosorbents (activated charcoal, polyphepan, etc.) and saline laxatives in the form of an aqueous suspension through the probe or orally

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

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

5. Infusion of 40% glucose solution 40 ml with 15 units of insulin iv

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

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

8. Symptomatic therapy depending on the complications arising (relief of seizures by sodium oxybutyrate, piracetam, etc.)

180. Acute adrenal insufficiency: etiopathogenesis, clinical features, diagnosis, treatment principles   - see question 75 (adrenal crisis).

181. Emergency measures for acute paroxysmal cardiac arrhythmias   - see question 32.

A little good alcohol helps increase blood circulation, shake oneself and uplift your mood. However, if the dose is exceeded, the consequences may be completely different. Intoxication occurs, the body begins to reject alcohol, and the person feels unwell. If alcohol poisoning occurs - what to do at home, how to overcome symptoms with the help of drugs or folk remedies, calm the stomach and tone yourself up.

What is alcohol poisoning?

When you consume a moderate amount of alcohol, ethyl is neutralized by the liver, and its decay products come out with urine. If the dosage of alcohol has been exceeded, or a person, through ignorance, drank a surrogate, the liver can’t cope, and harmful substances begin to interfere with the work of all the necessary systems of the body. As a result, alcohol poisoning is a complex of negative consequences, the appearance of which is associated with excessive consumption of ethyl alcohol.

Symptoms

External manifestations of intoxication appear gradually. At the initial stage of intoxication, a drunk person can be recognized by dilated pupils, not a firm gait, redness of the face, and a characteristic bad breath. With an increase in alcohol concentration, clouding of consciousness is observed, nausea may appear, vomiting may begin. After sleep, intoxication will remind you of a headache, dehydration, dizziness.

The symptoms of severe alcohol poisoning are much more serious. External manifestations include incoherent speech, loss of balance, lack of response to any external stimuli. With an increase in symptoms, alcohol damage begins to develop rapidly: loss of consciousness, weak breathing, blanching of the skin. In the extreme stage, a deep coma and even cardiac arrest are possible.

Treatment of alcohol poisoning at home

The body needs help to remove ethyl alcohol, neutralize toxins and other decay products. Therefore, the first aid for alcohol poisoning is gastric lavage. To clean the esophagus, artificial vomiting is necessary. You can use the folk method - drink a few glasses of salted water with soda. Manipulations must be done until the stomach is completely cleansed.

It is worth knowing that in a severe stage such a treatment of alcohol poisoning at home is simply unacceptable. The correct action in this situation is to call an ambulance or transfer the victim to the hospital on his own. While waiting, you should provide the following help: turn the person on his side, stick his tongue out to prevent the ingestion of gastric juice or food debris into the respiratory tract.

Calling a narcologist at home

Not everyone takes alcohol with euphoria. Some patients, while intoxicated, become violent, get into a fight, or try to commit suicide. In this case, drug treatment at home is ideal. Qualified specialists will help pacify the drinker, give the right medicines and put a dropper. In addition, if necessary, you can call an addiction specialist at home anonymously.

Dropper for alcohol intoxication at home

In extreme cases, or drunken alcoholics, doctors recommend putting droppers. They help to quickly cleanse the blood, remove the remnants of alcohol, bring the drinker to life without a trip to the hospital. Another undoubted plus of droppers for alcohol intoxication at home is the ability to adjust the composition based on the patient's history and symptoms.

Very often, the following drug combinations are used for treatment:

1. A solution of glucose with salt - to thin the blood. It helps replenish the amount of cerebrospinal fluid in the bloodstream.
2. Glucose 10% with magnesia plus insulin - to restore overall water balance.
3. Soda solutions - to prevent metabolic acidosis.
4. Electrolytes, butanedioic and maleic acid or sodium thiosulfate with unitiol - for the active elimination of alcohol from blood plasma and the body as a whole.
5. Glucose 5-10% with small doses of insulin - to increase blood sugar in the blood plasma and prevent oxygen deprivation of the brain.

What to drink with alcohol poisoning

If the degree is mild - what to do at home? You can try to recover without medical help: professional or improvised means. All absorbents available in the house are perfect: activated carbon black or white, enterosgel, sorbex and others. Try making simple decoctions of herbs. In addition, you need to drink a lot with alcohol poisoning, healing mineral water, water without gas, simple sweet tea.

Phytotherapy

From poisonous herbs, peppermint or lemon balm leaves, chamomile, grated ginger root, tansy, dill seeds effectively help with poisoning. For self-contained herbal medicine, try to prepare one or more decoctions according to the following schemes:

• Take 3-4 branches of lemon balm, mash with your hands and put in a thermos. Insist composition for at least two hours. Ready infusion is supposed to be consumed during the day.
• Two tablespoons of dill seed pour ½ a glass of water and boil for 5-7 minutes. Cool the drink slightly, divide into two halves. Apply according to this scheme: one part in the morning, the second in the evening.
• Grate or chop finely ginger root. Pour raw materials with a liter of boiling water, let it brew. Then add a little liquid honey, divide into 3-4 parts and drink in a day.

Drugs for the removal of alcohol intoxication

Along with affordable folk remedies, medications will help you get rid of the consequences of a noisy party. Preparations for the removal of alcohol intoxication can conditionally be divided into three parts:

1. Enterosorbents - help restore intestinal microflora, establish digestion, contribute to the normalization of stool. This group of drugs includes: activated charcoal, smecta, polyphepan, polysorb, enterosgel, algisorb and others.
2. Symptomatic drugs - accelerate metabolism, increase efficiency, fight migraines. Buy biotredin, zorex, limontar, yantavit, glycine, alkozeltser at the pharmacy.
3. Homeopathic remedies - break down alkodegillrosis, normalize metabolism. These include: Proproten 100 and Anti-E.

How to stop vomiting after alcohol poisoning

Very often, after a person’s alcohol, it stirs up, nausea appears, and attacks of vomiting develop. Doctors consider this to be the norm, but exactly to the extent that vomiting begins to appear on an empty stomach. There are several ways to stop vomiting after alcohol poisoning:

1. Attach a dense cloth dipped in ice water or ice cubes to the back of the head.
2. Try to arrange a detox in the house. Open all the windows wide, turn on the air conditioning.
3. Drink some cold water. If there are reducing drugs available, such as Regidron, then take the medicine.

With severe vomiting, it is important to take the correct position of the body. It is forbidden to tip over the victim on his back or throw his head back. So the vomit can enter the nasopharynx. In addition, it is advisable to look at the color of the released liquid. The presence of bile in the vomit or drops of blood should be the first signals that urgently need to call an emergency machine.

What can I eat after alcohol poisoning

Once the excess alcohol leaves the body, it is equally important to establish the right diet. In the first day after poisoning, if possible, it is better to refuse any food, replacing it with mineral water, tea, in an extreme case, chicken broth or crackers. On the second day, you can cook yourself lean dishes. Good help with rice cereals, semolina, boiled lean meat.

Eating after alcohol poisoning is necessary in small portions, and cook food only by steam or by cooking. The use of canned food, smoked meats, fatty or salty is not recommended. Follow these rules for poisoning you need only three days. During this time, the stomach will calm down, digestion will normalize, the microflora of the intestinal mucosa will return to normal. Then you can gradually expand your diet.

Alternative methods of treatment

How to remove alcohol intoxication at home? Try to put into practice traditional methods of treating a hangover:

• Make yourself drink yogurt, milk or yogurt. You should not hang out with beer or vodka, otherwise you can go into a binge.
• The next morning, drink a few tablets of allochol. If not, then activated carbon.
• To remove migraines caused by the use of alcohol, and increase efficiency can be aspirin or ascorbic acid.
• To restore the water-alkaline balance after eliminating alcohol, drink more water. A traditional brine, alkaline mineral water, juice or compote will do. No less effective is a sip of weak tea or coffee.
• To make treatment for alcohol intoxication faster, take a cold, then a hot shower. On the second day you can go to the bath.

The consequences of alcohol intoxication

Even with a small portion of alcohol after sleep, a person feels overwhelmed, a headache may appear, and working capacity may decrease. If the doses were significantly exceeded, then the consequences of alcohol intoxication are also displayed on the psyche. A sharp change of mood, psychosis appears, mental activity decreases, persecution mania may develop.

Toxic poisoning of the body can exacerbate chronic diseases or exacerbate those pathologies that were previously in a hidden form. In addition, excess alcohol on an ongoing basis leads to the risk of irreversible conditions: disorders in the liver, heart, brain. Chronic booze often suffers from psychosis, necrosis, peptic ulcer disease, arrhythmias, fibrosis, or cirrhosis of the liver.

Video: Treating alcohol poisoning at home

Alcohol poisoning is a very dangerous condition, against the background of which there are global disruptions in the work of all internal organs and systems. Often such a syndrome leads to the development of severe disability, and sometimes to death. Unfortunately, the vast majority of the inhabitants of our country already had a sad experience in dealing with alcohol.

How to understand that a person has received alcohol intoxication, what should be the first aid for alcohol poisoning? Such information should be known to everyone, because sometimes only immediate actions can save a person from death. Before the arrival of doctors, the victim can and should be helped at home.

With alcohol poisoning, it is extremely important to be able to correctly provide first aid

To date, several types of alcohols are known in medicine that cause severe poisoning of the body. These compounds differ in chemical structure and are the main culprits of intoxication..

1. Wine. This includes ethyl alcohol (ethanol), which is present in any form of alcoholic beverages. Ethanol is also found in some perfumes (perfumes, colognes, eau de toilette). Ethyl alcohol is also part of many medicinal tinctures and hygienic fluids (mouthwashes, skin lotion).
2. Woody. This group includes methyl alcohol (methanol). The compound on the basis of which some technical compositions are made (antifreezes, solvents, cleaning products).
3. Isopropyl. It is also used for the manufacture of industrial fluids and cleaning solutions.

Of course, there are many other alcohol compounds. But their use is much less common, since they are used extremely rarely in domestic needs. In addition, the remaining alcohol substances have a pronounced odor that distinguishes them from ordinary alcohol.

The degree of development of alcohol intoxication

According to WHO statistics, about 1.8 million people die every year from alcohol poisoning each year.

According to the observations of narcologists, the following situations are the main causes of alcohol intoxication:

• mixing alcohol with drugs or drugs;
• a state of binge, that is, continuous and prolonged consumption of alcohol, this condition is observed in the presence of chronic alcoholism in a person;
• poisoning by substitutes, many clandestine producers in order to reduce production costs, dilute vodka with surrogate alcohol (ethyl or methyl alcohols);
• excessive consumption of alcohol-containing products, poisoning occurs even when about 2.5 g / l is ingested (these indicators can vary and depend on the individual characteristics of a person).

Dangerous symptoms

The first alarming bells that a person has undergone alcohol poisoning may develop after 2-3 hours. Their brightness and duration depends on which substance the person has poisoned and how much he drank.

Especially dangerous is the situation with intoxication with methyl alcohol. In this case, the symptoms of severe poisoning can occur only after 1-2 days, and all this time the body of the victim will be destroyed.

Ethanol intoxication

With the abuse of large doses of alcohol, the concentration in the blood of ethyl alcohol increases sharply. The liver can not cope with the load and is not able to neutralize and remove toxic metabolites, their gradual concentration and leads to poisoning. With ethanol intoxication, almost all body systems suffer, in particular:

1. Nervous.
2. Endocrine.
3. Bronchopulmonary.
4. Digestive

According to statistics, the largest number of cases is poisoning with low-quality, surrogate alcohol

Ethanol poisoning can be suspected by characteristic signs. The first symptoms develop from the gastrointestinal tract:

• severe nausea, accompanied by profuse vomiting, so the body tries to get rid of the poison;
• a powerful pain impulse (the pain is localized in the peritoneum and intestines), the causes are inflammation of the mucous organs due to the action of toxic alcohol residues;
• diarrhea, the cause of this disease is the defeat of the pancreas toxins, this symptom is very dangerous, because a long stomach upset leads to dehydration.

Ethanol poisoning poses no less threat to receptors and brain cells.   With intoxication, brain tissue lacks the necessary oxygen and nutritious glucose.. Due to dehydration, vasospasm occurs. Nervous abnormalities with ethanol intoxication pass with the following symptoms:

• hallucinations;
• uncontrolled urination and defecation;
• cramps that can affect all the muscles of the body;
• increased anxiety, and sometimes aggressiveness;
• breathing problems, it becomes superficial and rapid;
• dizziness, leading to loss of consciousness, in severe cases, coma develops.

Methanol intoxication

The main symptoms of methanol poisoning are similar to damage to the body with ethyl alcohol. The main difference is visual impairment. Methanol leads to a sharp deterioration in the ability to see. The victim complains of clouding and reduced clarity of the observed picture.

Features of methanol intoxication

In the case of severe damage to the body with methyl alcohols, a person can completely and permanently lose the ability to see.

Ethylene glycol intoxication

Poisoning with this substance is also in its main symptomatology similar to damage to the body with ethanol. The main differences include kidney damage, which almost always occurs in the acute phase. The victim sharply decreases the amount of urine excreted, as a result of which the development of large foci of swelling is observed. Failure to work the kidneys leads to toxic damage to all internal organs and in severe cases to death.

Features of ethylene glycol poisoning

First aid to victims

Emergency care for alcohol intoxication should begin immediately, with the first alarming symptoms. The first thing that others should do is to call a team of doctors. Remember that self-medication in these cases is extremely dangerous. But first aid for intoxication should be provided, because the life of a person depends on it.

So, what should be the first aid for alcohol poisoning at home, the step-by-step actions of which must be known and remembered. Do not forget that such a disaster can come to everyone.

What to do with alcohol poisoning

Step 1. Cleansing the stomach

This procedure is necessary in order to remove the remains of toxic metabolites from the stomach. Cleansing will help improve the condition of the victim and stop the further spread of poison throughout the body.

It must be remembered that the poisoned person should clean the stomach only when the person is conscious. Otherwise, there is a high risk of fluid entering the lungs and choking with vomiting.

To empty the stomach, artificial vomiting should be provoked in the victim. It is easy to do. It is necessary to make a person drink 1-1.5 liters of ordinary water and put pressure on the root of the tongue. This procedure should be carried out several times. Keep in mind that you do not need to add potassium permanganate or other medicines to the water.

Step 2. Bowel Cleansing

After the stomach is washed, the remnants of the toxins must be removed from the intestine. After all, the toxic, poisonous decay products of alcohol are actively absorbed through the mucous membrane of the organ and worsen the human condition. This procedure is best done using an enema.

An enema is a necessary and important stage in providing first aid to a person who has suffered from alcohol poisoning.

To carry it out, it is necessary to use water of neutral (room) temperature. And, preferably, clean, without an admixture of herbal infusions, decoctions and medicines. The victim should be inflamed before the appearance of purified and clear wash water.

Step 3. Reception of sorbents

Adsorbing drugs effectively remove toxic substances from the body. These medications significantly accelerate the neutralization of alcohol and reduce the symptoms of intoxication. When using one or another sorbent, you should carefully study the attached instructions.

The consequences of alcohol poisoning

Remember that all these funds must be washed down with a large volume of water.   The liquid will help in the removal of poisons, increasing the ability of drugs to bind toxins.. The following medicines can be used as sorbents:

• Smecta;
• Atoxil
• Chitosan;
• Sorbex;
• Carbolen;
• Polysorb;
• Sorbolong;
• white coal;
• Enterosgel;
• activated carbon.

Step 4. Drink plenty

The victim should be given plenty of water. It is necessary to drink a person after the procedure of cleansing the intestines and stomach. Now you need to make up for the loss of fluid. Know that you should drink the poisoned little by little (in small and frequent sips). It is necessary that water is absorbed in the body. This will improve the general condition.

Milestone

In order not to forget how and in what sequence to carry out first aid to a person affected by alcohol intoxication, use this instruction. So, a step-by-step memo:

1. We call the ambulance team.
2. We provide the victim with access to fresh air. To do this, it is necessary to free a person from constraining clothes (unfasten buttons, loosen a tie, belt trousers) and open the windows wide.
3. If a person is unconscious, try to bring him to his senses. This will help ammonia or intensive grinding of the ears.
4. We carry out a gastric lavage. Consider that before the procedure, a person needs to be warmed. This can be done with the help of mustard plasters. They should be placed on the soles of the feet or hands.
5. Make sure that the victim is not lying on his back. If necessary, turn it on its side or on its stomach.
6. Put a cold on your head (you can use pieces of ice). Such an event well reduces the negative effect of alcohol toxins on the brain and stops the development of poisoning.
7. In case of moderate intoxication, give the victim a diuretic, one of the sorbents. If necessary, and a medicine that relieves a headache.
8. Then give the person hot tea. You can drink poisoned and light herbal decoctions.

What do doctors do

When the doctors arrive at the patient, describe to the specialists everything that and when the person took and in what quantity. Do not forget to tell about the first aid already provided (what drugs you gave, what you did). Separately tell the exact time of onset of threatening symptoms. Doctors will conduct a preliminary assessment of the condition of the victim.

General medical activities in case of alcohol intoxication are as follows:

• cleansing the stomach with a probe (carried out in an unconscious person);
• conducting infusion therapy (dropper) in order to relieve symptoms of intoxication;
• connecting the victim to pure oxygen (a special mask is used);
• resuscitation of cardiac activity (various medications can be used).

Then doctors will deliver the victim to the intensive care unit in the toxicology department. In the clinic, a person will take all the necessary tests and carry out subsequent treatment. The duration of hospitalization will depend on the general condition of the victim.

Remember that life can depend on the timely arrival of doctors and on your actions in case of alcohol intoxication. Therefore, do not waste a minute of precious time and do everything possible to save a person.

For the human body, alcoholic beverages are poison in the truest sense of the word.

A person in a state of intoxication is disturbed by the work of the brain, which entails neurological, mental and autonomic disorders.

The blood of a healthy person contains approximately 0.4 ppm of alcohol, which is absorbed into the bloodstream during fermentation in the intestines. Promille is a tenth of a percent. The condition when the blood alcohol level is higher than this indicator is called. If someone from your family has a habit of abusing alcohol and cannot stop on time, you need to know how to properly help with alcohol intoxication.

But in life, both in medicine and in everyday life, alcohol intoxication includes those cases of drinking alcohol when the dose of drunk is dangerous to human health and even human life. And in such situations, the indicator of the alcohol content in the bloodstream is often many times higher than the above figure. Because in order to know exactly the level of alcohol in the blood in domestic conditions, you have to navigate by the state of intoxicated.

The widespread belief that a small amount of alcoholic drink revitalizes thinking and improves performance is actually false. Even a small amount of alcohol leads to fatigue, work flaws, and difficulty remembering. With the systematic use of even small doses of alcohol, a person gradually turns into an alcoholic and feels somatic and mental discomfort in the absence of 100 g. In order to get rid of this unpleasant sensation, the drinker needs to drink.

Stages of intoxication

There are three stages of intoxication - mild, moderate and severe. The stage of mild severity is characterized by an elevated carefree mood in a drunken person, he is immersed in a state of euphoria; slight redness is noticeable on the skin, the pupils are dilated, urge to urinate becomes more frequent, and sweating increases. At the same time, the level of alcohol in the blood does not exceed 2%.

The stage of moderate severity occurs when the rate of alcohol in the circulatory system fluctuates between 2 and 3%. A drunk starts to sway when walking, he can double in his eyes, and his gait becomes uneven. Words spoken by a person in this state are becoming increasingly incomprehensible; he cannot give a correct assessment of the meaning of his phrases and actions. If a drunk is left alone at this stage, then he quickly falls asleep. In the morning, naturally, this person develops withdrawal symptoms (hangover): he feels overwhelmed, weak, feels an aversion to food and intense thirst, and nausea and vomiting are also possible.

Symptoms of acute alcohol intoxication are characteristic of a third, severe, when the alcohol content in the blood is above 3%. On this, a person may experience respiratory failure up to cardiac arrest. In some situations, stunning develops, followed by an alcoholic coma.

In acute alcohol intoxication, a person may die; while the amount of alcohol drunk for a short time in terms of pure alcohol is about 400 g. The state of acute alcohol poisoning is characterized by the following symptoms: respiratory failure, convulsions, dilated blood vessels of the eyes, excessive salivation.

The lethal dose of alcohol for humans is 8 grams of ethyl per 1 kg of weight.

If a person in this condition cannot be brought to life by strong shaking of the body or liquid ammonia, it is necessary to immediately provide first aid for alcohol poisoning. Removing alcohol intoxication with severe intoxication is feasible exclusively in the conditions of the toxicological department, otherwise the life of the victim will be at risk.

Symptoms of Alcohol Poisoning

It is very important to know that the symptoms that appear with alcohol poisoning are very similar to those with a stroke, kidney failure, or a predomatous state. First of all, it is necessary to immediately call an ambulance. A hallmark of a stroke is the paralysis that accompanies it, and the victim’s face is typically warped and a coma occurs instantly. The body of a person who has fallen into a coma due to a stroke should not be moved or touched until the doctors arrive. Renal failure is characterized by a coma, in which the ammonia smell is clearly distinguishable in a person’s breathing, and urination is scarce. In case of alcohol and drug poisoning, the pupils narrow to a minimum size.

Distinctive symptoms with:

• dizziness caused by a malfunction of the cerebellum;
• a headache that occurs due to the expansion of the cranial vessels after alcohol enters the blood;
• nausea and vomiting caused by ethanol acting on the cerebellum, which is responsible for balance;
• the next morning a hangover appears, there is a strong thirst, the reasons for which lie in a decrease in the amount of antidiuretic hormone, the function of which is to urinate.

Chronic alcohol poisoning is regular intoxication with derivatives of the breakdown of alcoholic beverages of the body. When alcohol enters the human body, it immediately reaches the liver, which takes on the function of a laboratory for the processing of toxic compounds. Under the influence of alcohol, liver cells begin to die, but this irreplaceable organ tries to recover and produces an enzyme that processes alcohol. A by-product of this process is acetaldehyde, which is highly toxic to the brain. It is because of this substance that in the morning of a person after a noisy party, all the horrors of a hangover are visited.

The cause of alcohol poisoning can be even a small amount of alcohol, especially if it is drunk by teenagers or people weakened after an illness. In these people, even a small dose of alcohol can lead to such a strong intoxication that only serious treatment can cope with its consequences.

Rules for emergency care for alcohol poisoning

Acute alcohol poisoning is characterized by excitation of the nervous system. It can be replaced by sharp oppression. The consequence of this stage can be an alcoholic coma. It is impossible to try to get a drunk out of this state on your own, as it carries a serious threat to the life of the victim. Every minute in this case is of great importance, therefore, it is immediately necessary to call an emergency narcological aid. The sooner the treatment procedures are carried out, the less harm alcohol intoxication will cause to the body.

It is in your power to provide first aid to the injured before the arrival of doctors.   Do not try to lay him on his back, as he may be choked with vomit; if the victim is already lying on his back, gently turn it over on its side. It is desirable that the patient lay on something soft - a sofa or bed. If a person is swooning, do not take gastric lavage measures as there is a chance that he will choke. Entrust the removal of the patient from a serious condition only to specialist narcologists.

In some cases, doctors arriving at home provide emergency assistance to the victim on site, and they can prescribe further treatment if the patient does not need to be transported to the hospital.

The list of rehabilitation methods after alcohol poisoning can include various medications and injections. Often prescribed a dropper at home.

If the alcoholic is at a severe stage of intoxication, and he has difficulty breathing and heart failure, it is necessary to immediately transport him to a medical institution. In this case, the help of a narcologist at home will not give the desired effect, since rescue measures that can be performed only in stationary conditions may be required to save the patient’s life.

First aid for mild to moderate alcohol poisoning

The fact that the brine helps with a severe hangover is false. Rather, the opposite is true: brine acid with alcohol forms unstable substances. They collapse after some time, and unpleasant ones reappear.

To accelerate the elimination of toxic substances from the body, it is necessary to take a diuretic and drink plenty of water.

It is clear that during drinking, you need to control yourself in order to exclude the possibility of severe alcohol poisoning. If you are going to a feast where you intend to drink alcohol, prepare in advance for this in one of the following ways:

• take 2-4 tablets of activated charcoal 10-15 minutes before drinking alcohol; do this every hour during the feast;
• you can drink one glass of milk before taking alcohol;
• 30 minutes before the holiday, eat one serving of buckwheat, oatmeal or semolina.

Alone or in combination with each other, these methods can have a positive effect on the prevention of alcohol poisoning.

Withdrawal symptom (hangover)

If you have not weakened the effect of alcohol on your body in one of the above ways, then after a lot of alcohol in the morning, you may feel dizzy, nauseous, very thirsty, lack of appetite. How to recover from a fun feast?

The best way to help yourself get rid of these troubles is to sleep. If you have the opportunity, try to sleep. If you need to work (study, meeting, etc.), take some kind of anti-hangover drug to ease it. Such medicines should be taken with a large volume of water. A warm shower also helps. The water-salt balance will help restore fish soup, fish soup, fresh tomatoes. To maintain intestinal microflora, drink some sour-milk drink. After a while, you can drink a cup of tea or coffee.

If you have not taken activated charcoal before and during the feast, it is not too late to take it in the morning, when the alcohol has already been fully absorbed. Activated carbon binds the decay products of alcohol and its residues in the intestine. But now you have to take a lot more (at the rate of 1 tablet per 10 kg of weight) and more than once. It is also necessary to drink it with a large volume of water. Take a walk in the fresh air - this gives noticeable relief in case of any poisoning, including alcohol.

Remember that all of the above ways to deal with a hangover are applicable only for mild to moderate alcohol intoxication. If all the measures you have taken do not give the desired effect, and the symptoms only worsen and new ones appear, you will need the urgent help of qualified specialists.

Alcohol intoxication, in which first aid was provided incorrectly or was not provided at all, can lead to serious consequences. For example, for a patient with atherosclerosis or hypertension, a severe degree of alcohol poisoning can result in a heart attack or stroke.

A person with diabetes with a large amount of alcohol can fall into a coma. In such cases, while preserving the life of the victim, he will need serious rehabilitation before recovering from acute intoxication.

Alcohol poisoning (mostly chronic) entails an exacerbation of an alcoholic's existing diseases that are associated with reduced immunity and neuroendocrine imbalance. Early hidden ailments are gaining strength, new ones appear, immunity to extreme environmental factors and heavy physical exertion is reduced. Most often, chronic alcoholics develop diseases associated with the cardiovascular system.

Therefore, you must always remember that any alcohol is a poison that can not be carried away. Take care of your health and the health of your loved ones.

Thank you for your feedback.

Comments

Megan92 () 2 weeks ago

And did anyone manage to rid her husband of alcoholism? My drink is not dry, I don’t know what to do ((I thought of getting a divorce, but I don’t want to leave the child without a father, and I’m sorry for my husband, he’s a great person when he doesn’t drink

Daria () 2 weeks ago

I’ve already tried so many things, and only after reading this article did I manage to wean my husband from alcohol, now I don’t drink at all, even on holidays.

Megan92 () 13 days ago

Daria () 12 days ago

Megan92, so I wrote in my first comment) Duplicate just in case - link to article.

Sonya 10 days ago

But this is not a divorce? Why are they selling online?

Yulek26 (Tver) 10 days ago

Sonya, what country do you live in? They sell it on the Internet, because shops and pharmacies put their mark-up atrocious. In addition, payment only after receipt, that is, first looked, checked and only then paid. Yes, and now they sell everything on the Internet - from clothes to televisions and furniture.

Editorial Response 10 days ago

Sonya, hello. This drug for the treatment of alcohol dependence is really not sold through the pharmacy chain and retail stores in order to avoid overpriced. To date, you can only order at official website. Be healthy!

Sonya 10 days ago

Sorry, I did not notice at first the information about cash on delivery. Then everything is fine for sure, if payment upon receipt.

The spread of poisoning

Alcohol poisoning for many years occupy a leading place among domestic poisoning in our country. More than 60% of all fatal poisoning is caused by this pathology. Of these, about 98% of deaths occur before the provision of medical care at the prehospital stage. Only 1-2% of patients die in medical institutions. About 90% of those hospitalized are patients with chronic alcoholism.

Alcohol poisoning (alcoholic coma)

General toxicological information

  Acute alcohol poisoning is usually associated with the intake of ethyl alcohol or various alcoholic beverages with an ethyl alcohol content of more than 12%.

Ethyl alcohol (ethanol C2H5OH) is a colorless liquid with a molecular weight of 46.07, a boiling point of 78.4 ° C, and is mixed with water in any ratio.

In the toxicokinetics of ethanol, two distinct distribution phases are distinguished: resorption (absorption) and elimination (excretion). In the first phase, the saturation of organs and tissues with ethanol is much faster than its biotransformation and excretion, as a result of which an increase in its concentration in the blood is observed. It easily penetrates cell membranes and is rapidly absorbed in the stomach (20%) and small intestine (80%). On average, after 1/2 h, its concentration in the blood reaches its maximum level. In organs with intensive blood supply (lungs, liver, kidneys), a dynamic balance of ethanol concentration in the blood and tissues is established within a few minutes.

Low concentrated alcoholic beverages (up to 30%) are absorbed faster. Food masses in the stomach slow down the absorption of alcohol due to their adsorption properties. When taken on an empty stomach, repeated doses, as well as in people with diseases of the stomach (gastritis, peptic ulcer), the rate of resorption is much higher. In the liver, 90% of ethanol ingested is oxidized (oxidation rate of 6–7 g / h) with the participation of the alcohol dehydrogenase enzyme according to the following scheme: ethanol -\u003e acetaldehyde -\u003e acetic acid -\u003e carbon dioxide and water (С2Н5ОН -\u003e СН3СНО -\u003e СН3СОО -\u003e CO2 + H2O).

Under ordinary conditions, a small fraction of ethanol (1-2%) is oxidized to acetaldehyde by the enzyme catalase, which is found in all tissues (muscles, etc.). This proportion increases significantly with alcoholic excesses and is an important part of the mechanism for the development of acute and chronic alcohol tolerance. About 10% of the absorbed alcohol is excreted unchanged through the lungs and kidneys within 7-12 hours. To determine the above phases of the distribution of ethanol (which is of great diagnostic and forensic value), the ratio of its concentration in urine and blood is calculated. In the resorption phase, this is the average ratio<1, а в фазе элиминации — всегда >1. The volume of distribution of alcohol is approximately 60 l / kg.

Pathogenesis of toxic effects

  Ethanol has a psychotropic effect associated with a narcotic effect on the central nervous system, weakening the inhibitory process. In severe poisoning, a weakening of the excitation processes occurs, which is due to a change in the brain cell metabolism, impaired function of the mediator systems, and a decrease in oxygen utilization.

The narcotic effect of ethanol depends on:

  a) the rate of resorption (the higher the increase in the concentration of alcohol in the blood, the more pronounced the narcotic effect at identical concentrations in the same patient);
  b) toxicokinetic phases (in the resorption phase, the narcotic effect of ethanol is higher than in the elimination phase at the same blood concentrations);
  c) concentration in the blood;
  d) the degree of development of the patient's tolerance to alcohol. An important role in the toxic effect of alcohol is played by the development of metabolic acidosis, the source of which is the acidic products of its biotransformation (acetaldehyde, acetic acid).

The lethal dose of ethanol with a single dose is from 4 to 12 g per 1 kg of body weight (an average of 300 ml of 96% ethanol in the absence of tolerance to it). Alcoholic coma develops at a concentration of ethanol in the blood of about 3 g / l, and a lethal concentration of 5-6 g / l.

The clinical picture of alcohol poisoning

  In the clinical course of acute alcohol poisoning, the most characteristic pathological syndromes can be distinguished. In the toxicogenic stage, a coma and other neurological disorders, disturbances in external respiration, and functions of the cardiovascular system are of the greatest importance; in the somatogenic stage - neuropsychiatric disorders, inflammatory lesions of the respiratory system, myorenal syndrome, withdrawal syndrome.

In the toxicogenic stage of poisoning, the severity of the patient's condition is determined by the depth of the coma and associated complications. Two stages of alcoholic coma are distinguished in two variants of the course: 1) the phase of superficial coma (uncomplicated and complicated); 2) the phase of deep coma.

The phase of superficial coma is manifested by loss of consciousness, lack of contact with others, a decrease in corneal, pupillary reflexes, and a sharp inhibition of pain sensitivity. The inconstancy of neurological symptoms is noted: a decrease or increase in muscle tone and tendon reflexes, the appearance of pathological eye symptoms ("pupil play", floating movements of the eyeballs, anisocoria), which are transient in nature. An increase in muscle tone is accompanied by a trismus of chewing muscles, the appearance of meningeal symptoms, myofibrillation with a primary localization in the chest and neck. The size of the pupils may be different, but more often myosis is observed.

In the clinical course of superficial alcoholic coma, two stages are distinguished, based on differences in the reaction to pain irritation. In Art. an injection or pressure in the pain points of the trigeminal nerve is accompanied by the expansion of the pupils, facial expression of the muscles of the face, and protective movements of the hands. A similar reaction is caused by the effect of ammonia (cotton wool moistened with 25% solution of ammonia is brought to the nose at a distance of 3-5 cm), as well as therapeutic measures (gastric lavage, subcutaneous injections, etc.). In II art. in response to such irritations, only mild hypertonicity of the arms and legs, myofibrillation appear; pupillary reaction is intermittent.

The phase of deep coma is expressed by a complete loss of pain sensitivity, the absence or sharp decrease in corneal, pupil, tendon reflexes, muscle atony, and a decrease in body temperature. The alcohol content in the blood and urine also varies over a fairly wide range (3.0-7.5 and 3.0-8.5 g / l, respectively).

Thus, the neurological symptoms of alcoholic coma, especially deep coma, are only a variant of the narcotic coma and can occur with a different etiology of a toxicohypoxic nature.

The electroencephalogram with various depth of alcoholic coma has characteristic changes: with a superficial coma - a disorganized delayed main activity (8-10 counts / s with an amplitude of 10-80 μV), against which synchronous flashes of delta activity regularly occur (1-4 counts / s with an amplitude of 60-180 μV) and theta activity (4-7 counts / s with an amplitude of 50-100 μV). With a deep coma, a monomorphic sinusoidal delta activity is observed (1–4 counts / s with an amplitude of 100–240 μV), against which single elements of the main brain activity are recorded (Fig. 3).

   Fig. 3. EEG with a deep alcoholic coma

  Disturbances of external respiration are caused by various obstructive-aspiration complications - retraction of the tongue, hypersalivation and bronchorrhea, aspiration of vomit, laryngobronchospasm. Clinically, they are characterized by stridorous rapid breathing, arrhythmia and disorganization of the act of breathing, acrocyanosis, swelling of the cervical veins, coarse bubbling rales over large bronchi. Aspiration of the acidic contents of the stomach often leads to the development of lung atelectasis or Mendelssohn syndrome (burn of the airways).

Respiratory failure according to the central type is a rarer complication, occurs with this pathology only in a state of deep coma. The most severe respiratory disorders are noted with a combination of these two forms. This is the leading cause of death of patients in the acute period of poisoning at the prehospital stage in the absence of medical care.

Respiratory disorders are accompanied by a violation of CBS blood. Metabolic acidosis in alcoholic coma is compensated to some extent by respiratory alkalosis. Disruption of compensatory capabilities leads to the development of combined decompensated acidosis.

Disorders of the cardiovascular system in alcoholic coma are nonspecific. The most constant clinical symptom, regardless of the depth of the coma, is tachycardia in most cases.

Blood pressure in superficial coma ranges from mild hypertension to mild hypotension, and then evens out. In a deep coma with an increase in the suppression of stem mechanisms of regulation of the vascular system, a decrease in vascular tone occurs, which causes a drop in blood pressure up to a collapse.

A study of central hemodynamics indicates the phenomena of hypovolemia, most pronounced in deep coma. Increased blood hematocrit, disorders of the blood coagulation system towards hypercoagulation in combination with acidosis and general hypothermia lead to a violation of the rheological properties of blood, which causes microcirculation disorders. Their clinical manifestations are pallor and marbling of the skin, acrocyanosis, injection of sclera.

ECG changes (ST segment decline, T wave negation, extrasystole) are most often observed with deep coma. They are intermittent and are reversible. These disorders are secondary, associated with general changes in homeostasis in alcoholic coma. There is no direct specific cardiotoxic effect of ethanol at very high concentrations in the blood. The observed hemodynamic disorders are mainly associated with a violation of the regulation of vascular tone. However, in the presence of chronic cardiovascular diseases, especially alcoholic cardiomyopathy, the development of persistent disturbances in the rhythm and conduction of the heart is possible. Late complications arising in the somatogenic stage relate primarily to the neuropsychic sphere of the body.

The way out of an alcoholic coma is not the same. Most patients experience periods of psychomotor agitation. After exhaustion of motor activity, excitement is replaced by a state of sleep. In the pre-dormant state in patients with chronic alcoholism, periods of psychomotor agitation are lengthened, and periods of falling asleep are shortened.

With motor excitement, short episodes of the illusory perception of the environment, auditory and visual hallucinations are sometimes observed. They are accompanied by a feeling of fear and anxiety, and after recovery, the patients assess it as a dream, interspersed with reality.

Significantly less often, as a rule, in individuals without a long history of alcohol, the transition from coma to consciousness is accompanied by adynamia, drowsiness, asthenia without psychomotor agitation.

Severe poisoning sometimes provokes the development of a convulsive syndrome, which most often occurs in the first hours after leaving a coma. An attack of clonic-tonic seizures is accompanied by respiratory failure due to trismus of the masticatory muscles, bronchorrhea and hypertonicity of skeletal muscles. However, it is usually resolved safely within a few minutes, followed by inhibition and asthenization of patients. Convulsive syndrome develops in streets suffering from alcoholic encephalopathy. Similar seizures in these patients, as a rule, are noted anamnestically.

In the post-coma period, people with chronic alcoholism develop a hangover syndrome. If in the complex of therapeutic measures insufficient attention is paid to its treatment, then some patients develop alcoholic delirium, which differs somewhat from the classically occurring delirium tremens. In persons who have undergone an alcoholic coma, delirious syndrome develops immediately after leaving a coma or after a few hours, i.e. virtually no period of abstinence from alcohol. It is relatively easy to treat, has an abortive, mitigated course.

Another, more rare, complication is alcoholic amaurosis. Sharply progressive loss of vision up to complete blindness develops within a few minutes. At the same time, the pupil width corresponds to illumination, a live pupil reflex is preserved. Alcoholic amaurosis probably has a psychogenic character and passes on its own, vision is fully restored within a few hours.

Inflammatory lesions of the respiratory system - tracheobronchitis and pneumonia - are one of the most frequent late complications that occur in people who have undergone aspiration-obstructive breathing disorders during a coma. They are characterized by rapid (first day) development and course. Pneumonia is localized mainly in the lower-posterior or upper (with aspiration syndrome) parts of the lungs.

Also a rare but most serious complication is myorenal syndrome. The inconvenient position of patients in a coma state (limbs tucked under themselves, bent at the joints) leads to compression of the main vessels of the limbs and a violation of their blood supply. General disorders of microcirculation with an alcoholic coma are aggravated by local (due to pressure by the mass of one's own body) or positional pressure on individual muscle groups. As a result, ischemic coagulation necrosis of the muscles develops.

When consciousness returns, patients complain of pain, restriction of movement, and increasing swelling of the affected limbs. The edema has a dense, woody consistency, circularly covers the limb, sometimes depending on the area of \u200b\u200bthe lesion spreads to the buttock or chest, usually on one side of the body. As a result of compression of the nerve trunks, neuritis develops with a decrease in all types of sensitivity. Myorenal syndrome is accompanied by the release of dirty brown urine containing myoglobin on the 1-2nd day and the development of toxic nephropathy. With delayed or insufficiently intensive treatment, acute renal failure develops.

Differential diagnosis of alcoholic coma

  Diagnosis of alcoholic coma is based on the clinical picture of poisoning, EEG data and laboratory studies.

The absence of obvious positive dynamics in a comatose patient within 3 hours against the background of the ongoing infusion therapy indicates unrecognized complications (traumatic brain injury, lung atelectasis, etc.) or cast doubt on the correct diagnosis of alcoholic coma.

The greatest difficulties are the differential diagnosis of this disease with coma caused by the following pathology, combined with intoxication:

• traumatic brain injury, acute cerebrovascular accident;
• poisoning by false substitutes for alcohol (chlorinated hydrocarbons, methanol, ethylene glycol);
• poisoning with sleeping pills and drugs, tranquilizers;
• hypoglycemic coma.

  Of the modern rapid methods for the quantitative determination of ethanol, gas-liquid chromatography has an indisputable advantage, which allows along with the main study to identify a number of substances characterized by narcotic action in biological fluids (methanol, higher alcohols, chlorinated hydrocarbons, etc.).

The average concentration of alcohol in the blood upon admission of patients in a coma is 3.5-5.5 g / l. There is no complete correlation between the depth of the coma and the concentration of ethanol in the blood, although there is a tendency to deepen the coma as the amount of alcohol in the blood increases. Moreover, the same concentrations are sometimes found in individuals in a state of intoxication and alcoholic coma. Therefore, a single indicator of the concentration of ethanol in the blood cannot serve as a criterion for the severity of alcohol poisoning. The diagnosis should be based on clinical data on the degree of coma due to the toxic effect of ethanol, the presence of which in the body is established by laboratory tests.

Comprehensive treatment of alcohol poisoning

  Patients in a state of alcoholic coma need intensive therapy, for which they are hospitalized in poisoning treatment centers or in other hospitals, where emergency diagnostic and resuscitation measures are possible. Timely medical care at the prehospital stage usually determines a favorable outcome.

Assistance should begin with the restoration of adequate pulmonary ventilation, depending on the form of respiratory failure. In cases of aspiration-obstructive respiratory disorders, an oral toilet is carried out, the contents of the upper respiratory tract are sucked out with the help of an air duct (with a superficial coma). Atropine (1-2 ml of a 0.1% solution) is administered subcutaneously to reduce hypersalivation and bronchorea.

In case of respiratory failure according to the central type, it is necessary to conduct mechanical ventilation after preliminary intubation of the trachea. With a mixed form of disorders, first remove the aspiration-obstructive respiratory disorders, and then turn on the mechanical ventilation. Inhalation of oxygen is indicated. Postural drainage and severe chest percussion are required to resolve atelectasis. After establishing adequate breathing, the stomach is washed through a probe, which is especially important in the phase of ethanol resorption, when its concentration in the blood is greater than in urine.

In severe hemodynamic disorders, anti-shock therapy is carried out: plasma-replacing solutions are administered intravenously - polyglucin, hemodez or reopoliglukin (400 ml); 400 ml of 5% glucose solution; 400 ml of physiological solution of sodium chloride with methadoxyl in a dose of 600 mg (10 ml) for accelerated elimination of toxic aldehydes, and with persistent hypotension - 60-100 mg of prednisolone intravenously in a glucose solution. Bemegrid or large doses of analeptics are contraindicated because of the danger of developing epileptiform seizures and obstructive respiratory disorders.

Gastric lavage through the probe is carried out in the lateral position (5-8 l of ordinary room temperature water in portions of 400-700 ml to clean wash water). Particular attention should be paid to the most complete removal of the last portion of the wash water. This is achieved by introducing the probe to different depths and moderate pressure on the patient's epigastric region. Neglect of this procedure sometimes leads to aspiration of washings during vomiting at the exit from a coma, when the endotracheal tube is removed after reflexes are restored.

If it is impossible to intubate the trachea for any reason, gastric lavage is not recommended for patients in a deep coma.

In order to correct metabolic acidosis, 600-1000 ml of a 4% solution of sodium bicarbonate are intravenously administered. With severe hyperosmolarity of the blood, noted with prolonged binges, hemodialysis is necessary. To accelerate the oxidation of alcohol, a 0.06% sodium hypochlorite solution is administered intravenously - 400 ml (via a central catheter to avoid damage to the vascular wall), 500 ml of a 20% glucose solution with 20 IU of insulin and a complex of vitamins (3-5 ml of 5 % solution of vitamin B1, 3-5 ml of a 5% solution of vitamin B6, 3-5 ml of a 1% solution of nicotinic acid, 5-10 ml of ascorbic acid), which are characterized by detoxification and contribute to the normalization of metabolic processes.

With a pronounced aspiration-obstructive syndrome of respiratory disorders, emergency sanitation bronchoscopy is indicated.

E. A. Luzhnikov, G. N. Sukhodolova