Alcohol coma

The coma ethyl alcohol is one of the most serious consequences of acute intoxication from ethanol.

 

Symptoms

As reported in the following table, the symptoms associated with alcohol intoxication are related to the levels of ethyl alcohol in the blood , also related to the individual habit of the toxic.

 

Alcohol ( g / l ) * Effects (indicative) **
   0.2 Sociability, expansiveness, flushing of the face
   0.5 Decrease of inhibitory brakes
   0.8-1.2 Depressive action on the motor centers, loss of self-control and balance disturbances
   1.2-2.0 Real drunkenness, staggering gait
   2.0-4.0 Loss of muscle tone, indifference to the surrounding environment, lack of reaction to stimuli, immobility, mutacism
   > 4.0 Unconsciousness and coma , respiratory and cardiovascular depression , death

 

(*) Alcohol level indicates blood alcohol levels and depends primarily on the quality and quantity of alcohol consumed

(**) Indicative, since, for the same alcohol level, the effects of alcohol depend on individual tolerance to the substance; in alcoholics, for example, the severity of intoxication is less, while adolescents and women can go into an ethyl coma already exceeding 2.5 grams per liter; alcohol in children above 2 grams / liter can be fatal.

 

Also keep in mind that:

  • alcohol is mainly absorbed in the small intestine, stomach and to a lesser extent in the large intestine ;
  • the peak blood concentration is reached 30-120 minutes after ingestion (more rapidly if on an empty stomach, if the intake is concentrated over time and if the alcoholic beverage is carbonatedrather than straight).
  • The simultaneous intake of other substances such as psychotropic drugsor drugs accentuates the disorders.

It is possible to calculate the indicative alcohol level – based on height , gender, amount of alcohol ingested and the time elapsed since drinking – with this simple form: calculation of the alcohol content .

 

Ethyl coma is accompanied by:

  • deep state of unconsciousness with classic halitosis, due to the massive elimination of alcohol at the alveolar level, and skin redness;
  • vasodilation and hypothermia, possible cause of death;
  • bradycardia and arterial hypotension;
  • respiratory depression.

Treatment

This is a real health emergency, which as such requires a quick rescue and transport to the hospital for medical intervention. Since there is no “antidote”, the therapy of ethyl coma is based on the correction of hypothermia, hypoglycemia and acidosis (decrease in blood pH ):

  • intravenousglucose , possibly associated with small amounts of insulin , for the correction of hypoglycemia ;
  • Fructose 1,6 diphosphate, thiamine , metadoxine and pyroglutamic acid, to accelerate the metabolism of alcohol;
  • Bicarbonateor sodium lactate , for the correction of metabolic acidosis ;
  • Saline solutionsto restore the hydro-saline balance;
  • Glutathione, to facilitate liver detoxification ;
  • Naloxoneat high doses, due to its non-specific awakening action (clinical results not entirely unambiguous);
  • Physical means to counter hypothermia;
  • Possible forced maintenance of breathing by artificial means.

 

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