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Alcohol Overdose

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* Alcohol (e.g., beer, wine, whisky, etc.), like any other drug when consumed in excess amounts, can lead to a serious overdose syndrome.
* When a person drinks alcohol at a rate faster than his liver can metabolize it, the alcohol accumulates in the bloodstream, subsequently affecting judgment and coordination, and possibly leading to loss of consciousness.
* When dealing with alcohol overdose, keep in mind that since the effects of the alcohol depend upon a variety of factors, such as body weight, number of drinks per hour, and individual metabolic rates, some (e.g., females, elderly) may develop toxicity (even death) at lower levels than others.

* Signs of overdose include declining heart, lung, and neurological functions (i.e., low pulse rate, decreased respiratory rate, Low Blood Pressure, and alteration in mental status and consciousness).
* These signs may precede circulatory collapse and death. Since blood alcohol levels are only a rough guide to severity of intoxication, doctors need to treat the patient and not his level, as blood alcohol levels as low as 0.25 have been associated with death.
* Others with a high tolerance may demonstrate little impairment at this level.
* BAC (blood alcohol concentration) charts do not take into account gender differences, body composition differences, use of medication, mood changes, or one's personal metabolic rate -- and physicians must take care when utilizing these values (see below) in treating alcohol overdoses.
* The body breaks down alcohol at a constant rate, with the liver's detoxifying approximately one-half ounce of alcohol per hour (less in some people, particularly women). One-half ounce is roughly the amount in a 12-ounce can of domestic beer, one ounce of 100 Proof liquor, or a 5-ounce glass of wine.

* Since intoxicated people tend to be non-cooperative and poor historians, an interview with anyone accompanying him or her may be helpful, to collect information about his or her medication and drug history, past medical and surgical history, allergies, and habits.
* A full physical exam is requisite, keeping in mind that taking alcohol with other drugs may have a depressant effect. Heroin, methadone, and some prescribed medicines like diazepam or Valium, and antihistamines increase the potential for overdose and death. Thus, as full a medical history as possible is important.
* In addition to alcohol level measurements, laboratory tests should include a chemistry panel and drug screen (to look for other possible drugs such as heroin, etc.).

* Careful monitoring of Arterial blood gases, oxygen saturation, and vital signs is necessary. These patients may need intravenous hydration and/or respiratory support with mechanical ventilator.

* The following is a generalized alcohol effect chart based on a 150-pound person, metabolizing 0.5 ounce of alcohol per hour, on a full stomach.
* The elderly and women are often affected by alcohol at lower dosages than healthy, 150-lbs males.
* BCA's Effect on the body:

1. 0.02 Slight alterations in mood
2. 0.06 Lowered inhibition (more likely to partake in risky behavior, e.g., unsafe sex), impairment of judgment, decreased rational decision-making abilities.
3. 0.08 Legally drunk -- decreased reaction time and control.
4. 0.15 Impaired balance, movement, and coordination; difficulty standing, walking, talking; at risk of falling.
5. 0.20 Decreased pain and sensation. Lability (wide swings) of emotions.
6. 0.30 Diminished reflexes. Semi-consciousness.
7. 0.40 Loss of consciousness. Very limited reflexes. Anesthetic effects.
8. 0.50 Death

* In short when you observe someone with slow respiration, clammy cold skin (may be bluish skin), and lack of consciousness and you suspect alcohol overdose call 911 immediately. Alcohol poisoning is a medical emergency and may lead to death.

* Signs and symptoms of other drugs, including street drugs, other-the-counter medications, and pharmaceuticals, may mimic those of alcohol overdose; or may be a complicating factor.



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