Alcohol poisoning restricts brain functions: Depending on the severity, alcohol poisoning manifests itself through imbalance, nausea and disinhibition – circulatory failure and even death are possible. This is how a slight swipe differs from an acute emergency.
- © iStock.com/Izabela Habur
Alcohol poisoning is the most common type of poisoning in Germany. In almost all age groups, men are more likely to be affected by alcohol intoxication than women. The number of children and adolescents affected by coma drinking and binge drinking has almost doubled in recent years. The consequences of poisoning with alcohol quickly become worse than headaches and nausea the next morning.
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Symptoms: how is alcohol poisoning manifested?
There are basically four stages of alcohol intoxication:
Excitation (0.2-2 parts per thousand blood alcohol): Even after consuming small amounts of alcohol, the first signs of disinhibition can be seen, for example through talkativeness. From a blood alcohol level of 0.3 per mille, a longer reaction time can be clearly demonstrated. With increasing alcohol consumption, balance disorders (staggering) and slurred speech (babbling) occur. The eyes are red and the perception of pain is reduced.
Hypnosis (2-2.5 per thousand blood alcohol): At this stage the effects increase. Serious speech, vision and coordination disorders occur, the muscles are slack and the pupils are narrowed. Those affected are often tired, but can still be woken up easily. The mood can easily turn into aggressiveness. The memory is impaired up to the "film tear".
Anesthesia (2.5-4 parts per thousand blood alcohol): In this state, unconsciousness occurs. The person affected no longer reacts to pain stimuli. It can lead to uncontrolled urination and stool, the pupils are dilated. Often these people are in a state of shock.
Asphyxia (over 4 per thousand blood alcohol): With extreme alcohol intoxication, the affected person shows dilated and unresponsive pupils. The protective reflexes fail, the body cools down extremely. Spontaneous breathing is impaired to such an extent that breathing may stop. There is a risk of circulatory failure, coma and multiple organ failure.
Causes: how does alcohol poisoning develop?
Alcohol poisoning is caused by an overdose of alcohol in the blood. There is no clear connection between the blood alcohol concentration measured in per mille and the severity of alcohol intoxication. Some people already show signs of intoxication at 0.8 per mille, others only at 2.5 per mille.
The faster the alcohol gets into the blood, the faster its concentration increases and the faster you get drunk. Usually the maximum blood alcohol concentration is reached after 60 minutes.
The following factors increase the recording speed:
warm alcoholic drinks
carbonated alcoholic beverages
Drinks with alcohol and sugar
The absorption of alcohol into the blood begins immediately after ingestion, as a small part enters the blood via the oral mucosa and esophagus. The rest is absorbed through the stomach lining and the intestines. The alcohol is distributed throughout the body via the blood and reaches the brain, where it changes the transmission between the nerve cells and triggers the classic symptoms of wellbeing to respiratory paralysis. Those who drink more slowly do not suffer from alcohol poisoning as quickly as the body breaks down about 0.1 per mille of alcohol per hour via the liver.
Alcohol concentration in the blood depends on the body water
Since alcohol dissolves better in water than in fat, the blood alcohol concentration depends heavily on the amount of water in the body. Heavier people usually have more body water and can therefore tolerate more alcohol. With the same weight, people with a higher fat percentage have less body water. Since the body water percentage of women averages 55 percent (men: 68 percent), the blood alcohol concentration for the same amount of alcohol consumed is usually higher in a woman than in a man with the same body weight. Women also have lower levels of the alcohol-degrading enzyme aldehyde dehydrogenase (ADH). Since children and adolescents are usually lighter, they are particularly prone to alcohol poisoning.
Even people with an atypical enzyme system (mainly Asians) can only tolerate very small amounts of alcohol. Some medications and diseases can also affect the way alcohol works.
First aid for alcohol poisoning
If acute alcohol intoxication is suspected, the person concerned must not be left alone under any circumstances. If he is conscious and can move independently, it is usually a matter of slight poisoning. In the event of severe poisoning, however, an emergency doctor should be called. Since alcohol dilates the blood vessels, drunk people can cool down quickly – even on a warm summer night. A blanket or jacket can prevent hypothermia.
Affected is conscious
If the drunk is conscious, it is best to induce vomiting. In this way, the alcohol that is still in the stomach is quickly removed from the body before it enters the bloodstream. It must be ensured that the poisoned does not choke on the vomit.
Often the typical choking noises are missing when vomiting: In the case of heavy alcoholism and unconsciousness, the vomit slowly trickles out of the mouth and the cough reflex is blocked. Often the problem is only noticed when the person concerned gasps for breath reflexively. The vomit must then be removed from the airways.
If the affected person can still swallow well and keep fluids to himself, he should be given water to drink to alleviate the symptoms of intoxication. To avoid falling, the drunk should sit down and accompanying persons should keep him conscious as far as possible.
What to do if you lose consciousness due to alcohol intoxication?
If you are unconscious or if your pulse is very weak, your breathing must be checked immediately. Mouth-to-mouth resuscitation is required if breathing has stopped, and cardiac massage if cardiac arrest. With normal breathing, the person should be placed in the stable side position. To ensure that vomit can drain off, the head should be positioned so that the mouth is the lowest point.
Diagnosis: This is how the doctor diagnoses alcohol poisoning
If the person concerned can be approached, the doctor will conduct a brief anamnesis, otherwise relatives or acquaintances will be asked. This will be followed by a physical exam to determine the severity of alcohol poisoning and to rule out other causes of the symptoms.
A blood sugar level that is too low can trigger symptoms similar to alcohol poisoning, especially in diabetics. If you are addicted to alcohol, sudden withdrawal from alcohol can also lead to symptoms that can be mistaken for alcohol intoxication.
If other diseases have been excluded, the doctor will determine the blood alcohol level with a blood test. In addition, blood pressure, temperature, breathing and pulse, electrolytes, kidney function and liver function are checked and an EKG is recorded. In particular, the doctor will assess the level of consciousness and check for signs of head injuries or the influence of medication or narcotics.
Therapy: This is how alcohol poisoning is treated
During sobering up, treatment for alcohol poisoning focuses on controlling and maintaining vital functions. Intensive medical surveillance may be required in the event of severe poisoning.
If the last alcohol consumption was not long ago, the stomach of the person concerned is pumped out in order to prevent further alcohol consumption. To stabilize the circulatory system, an infusion with saline solution may be given, and in the case of hypoglycaemia, a glucose solution may also be given. Disorders of the acid-base balance and the electrolyte level are also treated with appropriate infusions. If the person is very restless or aggressive, the doctor may consider medication to immobilize them.
If breathing stops, the person concerned is intubated and artificially ventilated, in extreme cases dialysis is carried out to detoxify and restore kidney function.
Course of the disease and prognosis
Mild alcohol poisoning usually heals without any consequences. Severe and repeated alcohol intoxication leaves massive physical damage in the long run – from a weakening of the immune system to liver cirrhosis, kidney and brain damage to diseases of the heart muscle and Korsakoff's syndrome. Often times, alcohol poisoning is also a sign of alcoholism.
How can alcohol poisoning be prevented?
The limit values for low-risk alcohol consumption in Germany are up to 24 grams of pure alcohol per day for men (this corresponds to two 0.3 liter glasses of beer or 0.25 liters of wine) and up to 12 grams of pure alcohol for women. Those who want to prevent alcohol poisoning should adhere to these limit values. Adolescents should be educated about the dangers of alcohol poisoning in order to encourage them to use alcohol more consciously.
If you drink slowly, avoid alcoholic beverages with sugar and carbon dioxide and drink enough water between drinks, you will get drunk much more slowly and ideally keep track of your alcohol consumption and the right time to stop.
Home remedies that do not affect alcohol poisoning:
Fatty meal before consuming alcohol: Eating only delays the absorption of alcohol into the blood, but the alcohol level at the end is the same.
Drinking strong coffee has no effect on blood alcohol
Chewing bay leaves does not prevent alcohol poisoning