Ethanol toxicity: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Classic Features | |||
**Slurred speech | |||
**Nystagmus | |||
**Ataxia | |||
**N/V | |||
**Respiratory depression | |||
**Coma | |||
*Other Features (if malnourished) | |||
**Hypoglycemia | |||
**Ketoacidosis | |||
**Lactic acidosis | |||
**Epigastric pain (pancreatitis) | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Diagnosis== | ==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== | ==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== | ==Disposition== | ||
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*[[Beer Potomania Syndrome]] | *[[Beer Potomania Syndrome]] | ||
== | ==References== | ||
[[Category:Tox]] | [[Category:Tox]] | ||
Revision as of 12:57, 1 June 2015
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)
Differential Diagnosis
Sedative/hypnotic toxicity
- Absinthe
- Barbiturates
- Benzodiazepines
- Chloral hydrate
- Gamma hydroxybutyrate (GHB)
- Baclofen toxicity
- Opioids
- Toxic alcohols
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