Symptoms of alcoholic poisoning following ingestion of a large amount of alcohol over a short period.
Cause
- Deliberate consumption of excessive alcohol in a short period of time
- Accidental ingestion (may occur in children)
Clinical features
- Smell of alcohol in the breath
- Slurred speech, uninhibited behaviour,
- Altered cognition and perception
- Nausea and vomiting
- Excessive sweating, dilated pupils
- Hypoglycaemia and hypothermia
- In later stages, stupor and coma develop
As coma deepens the following appear:
- Thready pulse and falling BP
- Fall in body temperature
- Noisy breathing
Differential diagnosis
Other causes of coma:
- Malaria and other intracranial infections
- Diabetes mellitus
- Head injury
- Stroke (cerebrovascular accidents)
Low blood sugar (hypoglycaemia) due to other causes
- Poisoning by other medicines e.g. narcotics
- Mental illness
Investigations
- Blood: alcohol content, glucose level
- Urine: for glucose and protein
- Lumbar puncture
Management
- Manage airways (ventilation may be needed)
- Correct hypothermia and hypovolaemia if present
- Check and correct hypoglycaemia with Dextrose
50% 20-50 ml IV- Give it via NGT or rectal if IV not available
- Maintain infusion of Dextrose 5-10% until patient wakes up and can eat
- Thiamine IV 100 mg in 1 L of Dextrose 5%