Ethanol toxicity: Difference between revisions
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==See Also== | ==See Also== | ||
*[[ | *[[Sedative/Hypnotic]] | ||
*[[Alcohol Withdrawal]] | *[[Alcohol Withdrawal]] | ||
*[[Beer Potomania Syndrome]] | *[[Beer Potomania Syndrome]] |
Revision as of 07:59, 7 February 2014
Background
- AMS that doesn't improve after few hrs is due to alternative cause until proven otherwise
- Blood Alcohol Level
- Correlates poorly with degree of intoxication
- Rate of ETOH elimination is 15-30mg/dL/hr (depending on degree of chronic alcoholism)
Clinical Features
- Classic Features
- Slurred speech
- Nystagmus
- Ataxia
- N/V
- Respiratory depression
- Coma
- Other Features (if malnourished)
- Hypoglycemia
- Ketoacidosis
- Lactic acidosis
- Epigastric pain (pancreatitis)
Diagnosis
- Blood sugar
- BAL
- Appropriate if AMS is due to unknown cause
- Not necessarily required in mild-mod intoxication or if no other abnormality suspected
- Elevated osmolar gap
Treatment
- GI decontamination
- Activated charcoal ineffective (ETOH is too rapidly absorbed)
- Hypoglycemia
- Give glucose immediately (do not have to wait to give thiamine first)
- "Banana Bag"
- IV form is not justified
- Likelihood of vitamin deficiency (except for thiamine) is low
- IVF does not hasten ETOH elimination
Disposition
- Most pts require observation only
- Can be discharged once patient at baseline mental status, able to tolerate PO, and road test successful
See Also
Source
- Tintinalli