Ethanol toxicity: Difference between revisions

Revision as of 16:29, 12 March 2015

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)

Classic Features
1. Slurred speech
2. Nystagmus
3. Ataxia
4. N/V
5. Respiratory depression
6. Coma
Other Features (if malnourished)
1. Hypoglycemia
2. Ketoacidosis
3. Lactic acidosis
4. Epigastric pain (pancreatitis)

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

GI decontamination
1. Activated charcoal ineffective (ETOH is too rapidly absorbed)
Hypoglycemia
1. Give glucose immediately (do not have to wait to give thiamine first)
"Banana Bag"
1. IV form is not justified
2. Likelihood of vitamin deficiency (except for thiamine) is low
3. IVF does not hasten ETOH elimination

Most pts require observation only
Can be discharged once patient at baseline mental status, able to tolerate PO, and road test successful

Authors:

@@ Line 18: / Line 18: @@
 ##Lactic acidosis
 ##Epigastric pain (pancreatitis)
+==Differential Diagnosis==
+{{Sedatve/hypnotic toxicity types}}
 ==Diagnosis==
 #Blood sugar
 #BAL
-##Appropriate if AMS is due to unknown cause
+#*Appropriate if AMS is due to unknown cause
-##Not necessarily required in mild-mod intoxication or if no other abnormality suspected
+#*Not necessarily required in mild-mod intoxication or if no other abnormality suspected
 #Elevated osmolar gap