Acute Alcohol poisoning: Tips for recognising signs and providing emergency treatment

by leeshakumar
Acute alcohol poisoning due to binge drinking

Teenage years are challenging years both for the adolescent and parents. There is an urge to try new thrills, new adventures, forbidden things and often develop rebellious behaviour. Teenagers may proclaim they tell their parents everything, yet, hide a lot more. If all goes well, consider yourself a lucky parent. For most of the other parents, there will be sporadic incidents of smoking, consuming alcohol, vaping or early sexual activity that marks their teenager’s life.

We all know the hype around most of the above, but in my knowledge, alcohol consumption is the most common, the most readily available and the most guilt-free abuse a teenager knows very early in his/her life. The earliest age group I’ve seen is a shocking 14 yrs. I believe the age span of 14-16 is especially vulnerable due to peer pressure and a sense of “premature adulthood”, a feeling that they are already adults and know it all.

What they do not know is that they can succumb to alcohol intoxication and death very quickly due to their risk-taking behaviour, their low body weight and delicate metabolism.

This article deals with facts, symptoms, dos and don’ts regarding alcohol poisoning. The intention is to create awareness that coma and death may occur due to irresponsible alcohol consumption. It is a reality. So, please be aware of the facts and help in spreading awareness. 

Facts about alcohol:

  • Alcohol, mainly ethanol acts as a central nervous system depressant. It slows thinking, movement, reflexes and speech depending on blood alcohol concentration (BAC).
  • Higher the BAC level, more the brain slows down.
  • Alcohol on reaching the stomach eventually passes to the small intestine from where it is absorbed into the blood and reaches the brain. The effect of food is to slow down the passage of alcohol into the small intestine as the stomach takes its time to digest the food. Therefore, eating food slows down the rise of BAC.
  • Alcohol on reaching the liver gets metabolised, and it is finally excreted through lungs and urine. Only once all the alcohol is thrown out of the body, the blood alcohol concentration returns to zero.
  • Short term risks of alcohol consumption include risk for accidents, violence and risky sexual behaviour.
  • Long term risks include high blood pressure, memory problems, mental health issues, social problems and dependence.
  • Binge drinking can cause alcohol poisoning/ intoxication and immediate death.

This post focuses on alcohol intoxication as the risk is plausible, and the awareness about this possibility is minimal.

How much alcohol can cause poisoning?

The concept of one standard drink has been defined as :

  • 12 oz (355 ml) of beer ( 5% alcohol content )
  • 8 to 9 oz ( 266 ml ) of malt ( 7% alcohol)
  • 5 oz (148 ml) of wine (12 % alcohol )
  • 5 oz (44 ml ) of 80-proof hard liquor ( 40 % alcohol )

Dangerous blood alcohol concentrations can be reached by binge drinking defined as consumption of > 5 drinks in men and > 4 in a woman within 1-2 hours, also subject to other risk factors like body weight, speed of drinking and food intake.

How does BAC relate to the stages of alcohol poisoning?

There are seven stages of alcohol intoxication depending on blood alcohol concentration ( BAC)

  • Sobriety ( BAC 0.01% to 0.05%) :Behaviour is nearly normal
  • Euphoria ( BAC 0.03% to 0.12%): Diminished attention and judgement, decreased inhibitions, talkative.
  • Excitement ( BAC 0.18% to 0.30%): Increased reaction time
  • Confusion( BAC 0.25% to 0.40%): Mental confusion, exaggerated fear/rage
  • Stupor (BAC 0.35% to 0.50%): Inability to stand or walk, vomiting, sleep/stupor
  • Coma ( BAC 0.45%): Complete unconciousness, Decreased reflexes, decreased temperature, Feeble pulse.
  • Death ( BAC 0.40 % or more )

What are the added risk factors affecting BAC?

  • Your overall health especially liver function status
  • Your body weight. Lower the body weight, the chances of reaching a higher BAC with few drinks is more.
  • Whether you have eaten recently. On an empty stomach, alcohol gets absorbed faster into the bloodstream.
  • The number of drinks. Binge drinking defined as >5 drinks in a male and >4 in a woman consumed over a short duration can reach lethal levels.
  • How fast you have consumed your drinks. Drinking too much in a short span of 1-2 hours can prove deadly.
  • The type of drinks consumed influences the alcohol levels
  • Mixing of drinks.
  • Gender: Women tend to reach higher BAC levels with the same amount of alcohol consumed as men.
  • Time: BAC will return to zero only with time once all the alcohol consumed is excreted out of the body.

Refer to BAC charts for your gender and weight to be aware of your safety limits.

What are the signs of alcohol poisoning?

  •  Confusion
  • Vomiting
  • Slow, irregular breathing
  • A long gap approximately 8-10 sec between breaths
  • Pale/ blue, cold skin
  • Feeble pulse
  • Seizures characterised by backward rolling of eyes, foaming at the mouth, biting of the tongue
  • Unconsciousness/ Passing out, cannot be woken up.

What are the complications of alcohol poisoning? 

  • Choking on vomit in an unconscious state
  • Asphyxia and death if breathing stops
  • Severe dehydration and markedly low blood pressure
  • Hypothermia that can cause cardiac arrest
  • Convulsions due to low blood sugar levels
  • Irregular heartbeat / Heartbeat stops
  • Irreversible brain damage
  • Coma
  • Death

Emergency and pre-hospitalisation steps:

Alcohol poisoning /intoxication is an emergency.

Just because you may have seen a few friends occasionally vomit and pass out after a happy evening, do not take this for granted.

If you are with someone who seems to be in the initial stages of confusion and vomiting and looks sick, do not leave them alone.

Do not wait for the symptoms to become severe and find yourself in a helpless situation when every second becomes a life threat.

A person who seems to have passed out may enter into unconsciousness where all the reflexes may be dulled. At this stage,  there may be a considerable risk of aspirating vomit into the lungs and death will quickly follow. This situation is the scariest and medically a challenge to revive a person.

You can help by making sure the person sits up if possible, or if unconscious, make them lie on their stomach with head to one side to prevent choking. Do not try cold showers as this can worsen hypothermia that could be setting in. Also, there is no role of black coffee at all.

Only with time, as alcohol gets metabolized and excreted will the BAC return to zero and symptoms subside.

Therefore, do not leave your friend/ family alone,  even if you have driven them home. Stick around. If you see any of the symptoms above, seek a doctor immediately.

Above all, never be afraid of medicolegal issues at this point and try to hide facts. All those can be dealt with later.

“To save a person’s life should be a top priority.”

As soon as medical help arrives, provide as much information as you can regarding the amount /speed of alcohol consumed, symptoms, and chronology of events. This information will be a big help to the doctors in planning their management protocol.

How can you prevent alcohol poisoning?

Avoid Binge drinking at all costs.

Drinking too much too fast is never a good thing for any adult, leave alone teenagers.

Avoid drinking on an empty stomach

Avoid mixing drinks.

Look up BAC charts and make yourself aware about your own safe drinking limits according to body weight and gender.

It is essential and unavoidable to talk to teenagers about responsible drinking. Parents are often faced with the dilemma, whether conversations such as these would give a wrong message, possibly one that they were permitting them to drink. In my opinion, teenagers will try alcohol at some point. Conversations at the right age would mean that they at least have the awareness that drinking could quickly get out of hand and turn dangerous. If anything else, the knowledge will encourage them to recognize a friend in trouble and provide proactive help.

Responsibility comes with communication. The idea of this blog post is to create a sense of social responsibility both for parents and adolescents.

Please feel free to interact for information or advice through the comment box below or subscribe to my newsletter on related issues.

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