In alcohol poisoning (alcohol intoxication), brain functions are disturbed by an overdose of alcohol. This leads to the typical signs of alcohol intoxication such as impaired balance, nausea and vomiting, and disturbances in consciousness. Severe alcohol poisoning can also have long-term health consequences. Read more on the topic here: From how much per mille does alcohol poisoning threaten? What are the possible symptoms? What does the doctor do?
What to do in case of alcohol poisoning? Patients who are conscious: make them drink plenty of water, keep them soft and stable, keep them warm, check their breathing regularly. Unconscious patients: place in the recovery position, keep warm, call an ambulance.
Alcohol poisoning – risks: Chilling, organ damage/failure, respiratory and/or cardiovascular arrest
What does the doctor apply? Depending on the severity of the alcohol intoxication, administer fluids by infusion, monitor vital functions (heartbeat, breathing, etc.), dialysis or ventilation if necessary.
In small doses, alcohol only has a selective effect on the brain regions that control our emotions. For higher doses, however, it paralyzes the entire central nervous system.
In addition to the drinkable alcohol (ethanol), many alcoholic beverages also contain “fusel alcohols” such as isopropanol and methanol. In higher doses, they can damage health and intensify the intoxicating effect.
Alcohol poisoning: symptoms
There are smooth transitions between a mild buzz and tangible alcohol poisoning. The symptoms that occur change with increasing alcohol consumption – faster in some people, slower in others (see below: Causes and risk factors):
A mild alcohol intoxication (“buzz”) often feels pleasant, at least initially. The head is light, you feel loose, a warm feeling spreads through the body.
If one continues to drink, changes in character and behavior occur: Some sufferers become euphoric, others sad, still others aggressive or very clingy. Increasingly slurred pronunciation (slurring) also occurs. In addition, the drunk is increasingly unsteady on his feet: standing and walking (staggering!) no longer work so well because the sense of balance is impaired.
Problems with orientation and a reduced ability to react also accompany the increasing alcohol intoxication. Nausea and even vomiting soon set in.
As alcohol intoxication progresses, symptoms such as disturbances in thinking functions, perception and consciousness appear. For example, cold is no longer perceived, and the drunk is hardly responsive. He may eventually become unconscious and even fall into a coma (alcoholic coma). This can lead to respiratory arrest! There is also a danger to life because in severe alcohol intoxication, protective reflexes such as the cough reflex fail. Vomit can then enter the respiratory tract – there is a danger of suffocation!
In the case of the most severe alcohol poisoning, the entire cardiovascular system can finally collapse. Without quick help, alcohol poisoning then leads to death.
Stages of alcohol intoxication
Doctors distinguish the following stages of alcohol intoxication:
Excitation stage (1 – 2 per mille in blood): low drunkenness, slight gait disturbance, feeling of relaxedness, carelessness and disinhibition, talkativeness, overestimation of oneself, imprecise reactions, etc.
Hypnosis stage (2 – 2.5 per mille): the drunk tends to sleep, but can still be woken up. In addition, severe balance disorders when walking, slowed perception, slowed thinking, clear and often aggressive mood, etc.
Narcotic stage (2.5 – 4 per mille): deep unconsciousness, reflexes fail, decreased sensitivity to pain, muscle flaccidity, shock, etc.
Asphyxia stage (> 4 per mille in blood): circulatory and/or respiratory disorders, rapid chilling in the cold (risk of frostbite), possible death.
Alcohol poisoning: What to do?
There are no home remedies or any antidote at all for alcohol or alcohol intoxication. Fresh air, a cold shower or a painful stimulus (e.g. a juicy slap in the face) can make the affected person seem more alert again for a short time. However, such measures have no influence on the effect of the alcohol.
If you suspect someone has alcohol poisoning or see signs of it, the first thing you should do instead is check their consciousness: Talk to the person or gently shake him or her. Also check to see if the person might have a (head) injury that could have caused the symptoms.
Further first aid steps for alcohol intoxication depend on whether the person is conscious or not:
Drunk person conscious:
Stop alcohol consumption: make sure the drunk person does not drink any more alcohol.
Vomiting: Vomiting (even purposefully induced) carries residual amounts of alcohol out of the stomach.
Plenty of water: If the person can keep liquids down, you should give him plenty of water to drink.
Rest and sleep: Sleeping off the intoxication usually brings drunks (slowly) back to their feet. Cover him up while you do this to prevent him from getting chilled.
In the case of mild alcohol intoxication, “treatment” is possible at home. In most cases, the intoxication can be “slept off” without medical intervention. Nevertheless, you should not leave the affected person alone for the duration of the intoxication symptoms.
Unconscious drunk person:
Recovery position: If someone with severe alcohol intoxication is unconscious, you should immediately place them in the recovery position with their head extended. This will prevent vomit from entering the trachea.
Warming: Alcohol virtually overrides the control mechanism for maintaining core body temperature. Therefore, keep the unconscious person warm (e.g., with a blanket).
Call an ambulance: Alert the emergency physician and stay with the intoxicated person until he arrives.
If necessary, resuscitate: Until rescue arrives, check regularly whether the unconscious person is still breathing. If breathing stops, you must start resuscitation immediately!
Alcohol poisoning: causes and risk factors
The extent of alcohol poisoning does not always correlate with the amount of alcohol consumed. This is because the severity of the symptoms of alcohol poisoning and their duration depend, on the one hand, on the physical condition of the person affected at the time of alcohol ingestion (fluid and food intake in the hours before, rested ness, underlying diseases, etc.). On the other hand, the physique of the affected person (e.g., very tall, athletic, thin), how old he or she is, and how accustomed he or she is to alcohol consumption play a role.
For example, people who consume alcohol frequently usually show fewer symptoms than those who rarely or rarely drink alcohol. People with low body weight (such as children and adolescents) are more susceptible to alcohol poisoning. People with brain damage (such as due to a medical condition) also have an increased risk of alcohol poisoning after drinking even very small amounts of alcohol.
What happens in the body
The liver breaks down the alcohol in the blood. However, its degradation capacities are limited. If they are exceeded, ethanol, fusel substances, and also toxic breakdown products accumulate in the blood. Ethanol changes the structure of nerve cells so that they no longer function properly or destroy themselves. This result in the typical symptoms of drunkenness – up to and including alcohol poisoning.
Danger from high-proof and intoxicating drinks
Alcohol poisoning can occur particularly easily when someone drinks high-proof drinks (such as vodka). Even a relatively small number of glasses can contain large amounts of alcohol. By way of comparison, a bottle of vodka (750 ml) contains as much pure alcohol as six liters of beer.
Binge drinking, i.e. the consumption of large quantities of alcohol within a short period of time, is also dangerous. Binge drinking with high-proof alcohol in particular can quickly lead to alcohol poisoning. The liver then has to cope with a high dose of alcohol at once. The first mild signs of alcohol intoxication then usually fail to appear. Instead, severe intoxication sets in suddenly and directly.
Alcohol poisoning: examinations and diagnosis
First, the doctor tries to obtain important background information in a short conversation (anamnesis). If it is no longer possible to talk properly to the drunk person, the doctor will turn to other people present (relatives, friends, etc.) for this.
This is followed by a physical examination. This allows the doctor to assess the severity of the alcohol intoxication.
He then measures the blood sugar level of the person affected. Diabetics in particular, whose blood glucose levels are too low, may experience symptoms similar to those of alcohol poisoning.
Blood values and drug screening
At the hospital, doctors also measure the alcohol concentration in the drunk person’s blood. Especially in the case of chronic alcoholics, they must also determine other blood values, as concomitant diseases can lead to complications.
Since the person concerned may also have taken other drugs, knowingly or unknowingly, the doctor also carries out a so-called “drug screening”. For the therapy, it is important to know whether other substances have caused the poisoning or intensified the symptoms.
What the doctor must also take into account: In some cases, the symptoms of alcohol withdrawal syndrome resemble those of alcohol intoxication.
Alcohol intoxication: treatment
In the case of alcohol intoxication, the doctor tries to relieve the symptoms and prevent complications. In addition, the patient must not have the possibility of endangering himself. For individual cases, treatment is based on the type and extent of the symptoms of alcohol intoxication.
First, the affected person is given fluids through a venous line. In most cases, the drunk is allowed to “sleep it off” under observation – with continuous monitoring of heart function, oxygen saturation, blood pressure and blood sugar. Severe alcohol intoxication requires monitoring in an intensive-care unit. If kidney failure is imminent, dialysis is usually necessary; if breathing stops, ventilation is required.
If the drunk is very agitated or aggressive, the doctor usually administers a sedative medication. In exceptional cases, affected persons are restrained for their own protection.
Alcohol poisoning with toxic alcohols such as methanol or isopropanol must usually be treated by the doctor with medication.
Alcohol poisoning: consequences
As a rule, mild alcohol poisoning heals without consequences. However, repeated or severe alcohol intoxications can cause damage to the brain, liver and kidneys. In particularly severe cases, alcohol poisoning is fatal.