Ethyl coma represents one of the most serious consequences of acute ethanol intoxication.
Symptoms
As reported in the following table, the symptoms associated with alcohol intoxication are related to the levels of ethyl alcohol in the blood, also in relation to the individual habit of the toxic.
0,2
Sociability, expansiveness, redness in the face
0,5
Decrease of inhibitory brakes
0,8-1,2
Depressive action on the motor centers, loss of self-control and disturbances of balance
1,2-2,0
Real drunkenness, staggering gait
2,0-4,0
Loss of muscle tone, indifference to the surrounding environment, lack of reaction to stimuli, immobility, mutacism
> 4,0
Unconsciousness and coma, respiratory and cardiovascular depression, death
(*) The alcohol level indicates the levels of alcohol in the blood and depends primarily on the quality and quantity of alcohol consumed
(**) Indicative, since, with the same alcohol level, the effects of alcohol depend on individual tolerance to the substance; in alcoholics, for example, the severity of intoxication is less, while adolescents and women can go into an ethyl coma already exceeding 2.5 grams per liter; alcohol in children above 2 grams / liter can be fatal.
Also keep in mind that:
- alcohol is mainly absorbed in the small intestine, stomach and to a lesser extent in the large intestine;
- the peak blood concentration is reached 30-120 minutes after ingestion (more rapidly if on an empty stomach, if the intake is concentrated over time and if the alcoholic beverage is carbonated rather than straight).
- The simultaneous intake of other substances such as psychotropic drugs or drugs accentuates the disturbances.
It is possible to calculate the indicative alcohol level - based on height, gender, quantity of alcohol ingested and the time elapsed since drinking - with this simple form: calculation of alcohol content.
The ethyl coma is accompanied by:
- profound state of unconsciousness with classic halitosis, due to the massive elimination of alcohol at the alveolar level, and skin redness;
- vasodilation and hypothermia, a possible cause of death;
- bradycardia and arterial hypotension;
- respiratory depression.
Treatment
This is a real health emergency, which as such requires rapid rescue and transport to the hospital for medical intervention. Since there is no "antidote", the therapy of ethyl coma is based on the correction of hypothermia, hypoglycemia and acidosis (decrease in blood pH):
- intravenous glucose, possibly associated with small amounts of insulin, for the correction of hypoglycemia;
- Fructose 1,6 diphosphate, thiamine, metadoxine and pyroglutamic acid, to accelerate the metabolism of alcohol;
- Bicarbonate or sodium lactate, for the correction of metabolic acidosis;
- Saline solutions to restore the hydro-saline balance;
- Glutathione, to facilitate liver detoxification;
- Naloxone in high doses, due to its non-specific awakening action (clinical results not entirely unambiguous);
- Physical means to counter hypothermia;
- Possible forced maintenance of respiration by artificial means.
For less severe cases see the in-depth article: Hangover Remedies
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