Alcoholic poisonings
Alcohol (spirit of wine) – is a part of alcoholic beverages, spirits, cologne, medicinal vegetable infusions, is solvent for spirit varnishes, alkaline lacquer, fining agents. Lethal concentration of ethyl alcohol in blood: about 300-400 mg.
Symptoms. At light intoxication a leading sign is euphoria(The raised mood). At intoxication of centre weight joins infringement of gait and coordination of movements, moderate excitation, which it is replaced by drowsiness and a penetrating sleep. These stages of intoxication of treatment not demand. At a heavy poisoning all phenomena are expressed more strongly and intoxication concludes a narcosis, i.e. a penetrating sleep with loss of all kinds of sensitivity, including pain and temperature. And though this state itself but is not dangerous itself to life as passes in some hours, but in a narcosis state heavy traumas, occurrence of penetrating tumours, up to a gangrene of the soft fabrics invoked by infringement of an aboriginal circulation at a sleep in the same inconvenient position are possible. Essential danger is represented by a frigorism. It can arise even at air temperature 12°С. Thus the body temperature drops till 31-32 With, sphygmus drops till 28-52 impacts, breath is oppressed till 8-10 in minute. Such combined lesion very dangerously also can lead destructions or in the first days from infringement of breath or the proximate weeks from pneumonia and gangrenes of the lungs invoked by a frigorism. At very heavy alcoholic intoxication of the patient all quickly passes the previous stages of intoxication (euphoria, excitation, a narcosis) also runs in penetrating coma.
Distinguish three stages of a coma.
Recognition. The alcoholic coma should be distinguished with a stroke, an uraemic coma, a poisoning with morphine and its derivatives. An odour of alcohol from mouth proves nothing, as focal lesions are possible. The stroke is accompanied by a paralysis of half of body with a deflection of an eye towards a lesion more often. Thus the coma more penetrating, than alcoholic, also comes routinely subitaneously. At an uraemia the odour of ammonia from a mouth is characteristic, pupils that are narrowed to the centre dimensions extend. The diuresis is absent or is extremely poor, while at alcoholic a diuresis vomitings, an involuntary defecation are on the contrary increased, frequent. The coma morphine is characteristic sharp narrowing of a pupil to the dimensions of “a pin head”, conserved tendon jerks. Leading sign for the diagnosis in an inconvenient case is definition of quantity of alcohol in blood that is possible only in the conditions of a specialised hospital. The alcoholic coma is routinely short, some hours proceed. Its duration in a combination to sharp infringements of breath is more than days an unfavorable sign.
First aid. At very grave condition (clod) should be vigorous, especially at breath infringement. At falling of arterial pressure appoint cardiovascular means (ephedrine, strophanthin. The main thing at intoxication treatment – to stop an adsorption of alcohol, abundantly to flush a stomach through a sonde. It also deduce from an organism at the help of intravenous introduction of a hypertonic solution of glucose with an insulin; in a penetrating coma it is expedient to use a method of the forced diuresis, therapy by vitamins. From emetic means-only ephedrine hypodermically, but also it is counter-indicative in the absence of consciousness, and also at low arterial pressure, a strong general attrition, that quite often meets at alcoholics. To consciousness restoration apply also ammonia solution inside (5-10 drops of liquid ammonia on a water beaker). As at the patient the acidosis it is necessary to introduce solution of sodium of a hydrocarbonate into a vein or in (2-7 g of baking soda on reception) educes. Warming sick of hot-water bottles is obligatory, especially at a combination of intoxication to refrigerating. At excitation it is not necessary to yield for abirritation of the patient of drugs of bunch of morphine because of dangers of oppression of breath. In that case it is necessary to introduce aminazine or hydrochloride no more than 0,2-0,5 g with starchy mucus. To the patient it is necessary to yield hot strong sweet tea or the coffee containing in these beverages caffeine promotes stimulation of breath, warmly vascular systems and to awakening.