THE MEDICAL MANAGEMENT OF INTOXICATION
Acute intoxication with alcohol progresses from euphoria to incoordination and ataxia, to confusion, stupor and coma. The blood level of alcohol at which these stages occur is lower in women and children but higher in those physically dependent on alcohol. In all cases other causes for apparent intoxication should be sort including head injury and hypoglycaemia. Toxicological analyses and careful observation are essential together with a strong awareness of the risk of accidental or intentional overdose. Parenteral thiamine should always be
given before glucose if hypoglycaemia is to be treated, to prevent precipitation of Wernicke's Encephalopathy.
ALCOHOLIC COMA
This serious disorder has a mortality rate of 5%. Admission to hospital is essential to maintain vital functions and counteract other conditions that may threaten. Inhalation of vomit and resulting acute respiratory distress due to Mendelson's syndrome is frequently fatal. It is necessary to monitor vital functions to avoid metabolic complications such as lactic or keto-acidosis, hypoglycaemia, hyponatraemia etc. Many interventions may be necessary including haemo- and peritoneal dialysis, to prevent death.
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The above information is copyright of Dr Bruce Trathen MBBS MRCPsych (2006). ISBN 0-9545164-0-0. The author grants permission for these guidelines to be downloaded, copied and distributed freely, but does not grant permission for their sale.
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