Alcohol Poisoning

Question 1

How does alcohol poisoning/toxicity occur?

Answer 1

• Occurs after drinking large amounts of alcohol in a short time.
• ​The liver can only detoxify approximately one ounce of alcohol every 90 minutes making binge drinkers at high risk for toxicity.
• This is a serious condition and can be fatal.

Question 2

What are the subjective/physical exam findings associated with alcohol toxicity?

Answer 2

• Subjective: emotional lability, impaired coordination, nausea, vomiting, facial flushing, diaphoresis, bluish skin tone.
• Physical: Respiratory depression, electrolyte and acid base disturbances, stupor, seizures, tachycardia, hypotension, hypoglycem_ia. Presentation is much more pronounced than drunkenness._

Question 3

What lab tests are associated with alcohol toxicity?

Answer 3

Blood alcohol levels ranging from 50%-100% (mild toxicity), 100%-300% (moderate toxicity), more than 300% (severe toxicity)

Question 4

How do you manage a patient with alcohol toxicity?

Answer 4

• ABCs, watch oxygenation. Usually requires hospitalization
• Hemodialysis may be needed to reduce ethanol levels in severe toxicity
• IV glucose 200-500 mg/kg/dose as D50%W or 50% dextrose in patients with suspected hypoglycemia
• Alcoholics require pretreatment with thiamine (100 mg IV/IM/PO daily for at least 3 days), multivitamin (1 tablet PO/NGT daily) folic acid (1 mg PO daily), fluids and electrolytes PRN