Symptoms/Signs

There is no clear definition as to what per mille value is required to be considered as alcohol poisoning. Rather, one is guided by symptoms such as unconsciousness or respiratory arrest. In principle, one speaks of alcohol poisoning in every patient who is admitted to hospital because of his alcohol consumption.

This is usually the case when relatives or friends are worried because the person concerned is unconscious and calls the emergency services. In addition to unconsciousness, hypothermia and – in the case of very high blood alcohol levels – breathing and pulse irregularities may also occur. This is an absolute indication for in-patient care in hospital, as these are signs of a potentially fatal state of consciousness.

Symptoms that can occur before alcohol poisoning, but are not fatal on their own, are vomiting, headaches, palpitations, insecure gait, speech insecurity, memory loss (“film tear”), aggressiveness and disinhibition. The next day vomiting, headaches, dizziness, noise and light sensitivity as well as blurred vision and diarrhoea occur. Headaches are caused by a dilation of the blood vessels in the brain, which then press on surrounding structures.

The palpitations after alcohol can have various causes. Stomach pain and heartburn are the result of increased acid production in the stomach. In addition, the body is dehydrated because alcohol causes increased urine excretion, as it inhibits the excretion in the brain of a hormone that is important for the concentration of urine (“antidiuretic hormone”).

Since in the intoxication against thirst usually no water but further alcohol is consumed, a vicious circle develops. The alcohol also inhibits the absorption of water in the small intestine, which results in dehydration and diarrhoea. In very severe cases Imodium can be taken against diarrhoea, but since it is a short-term phenomenon that is usually gone after one day, it should be carefully weighed. In order to relieve the symptoms, it is, of course, first and foremost advisable to know your limit and to stop drinking at a certain point. If this is no longer possible, an attempt must be made to remove the alcohol from the body if possible, or to dilute it.

Therapy

Acute alcohol poisoning in hospitals is usually monitored in an intensive care unit. Since they can be potentially fatal, particularly intensive care is required. If the last alcohol consumption was only a few minutes ago, the stomach can be pumped out in the first instance to prevent further alcohol intake.

If high blood alcohol levels of more than 4 per mille are already reached, emergency dialysis – as blood washing – can be initiated. This involves pumping the blood out of the patient, cleaning it outside the body in a centrifuge, and then returning it to the patient. Such procedures are usually reserved for patients with terminal kidney failure.

To alleviate the effects the next day, a saline solution can be added to rehydrate the body and dilute the alcohol level in the blood. In case of deep unconsciousness, patients must also be placed in the stable lateral position to prevent aspiration with vomit. The latter ends in the best case with pneumonia, in the worst case with death.

Self-induced vomiting, fresh air and plenty of water are suitable for self-therapy. The aim is to remove or dilute the alcohol from the body as quickly as possible. If you find an “alcoholic corpse” at a party in the evening, many ask themselves what they can do now: First of all, the alcoholic should be spoken to aloud and if necessary a painful stimulus should be given.

This can be done by rubbing the breastbone, for example. If there is no reaction, the patient should be moved to a stable lateral position and the rescue service should be informed. The alcoholized person should be observed until the rescue service arrives.

Vomiting does not “unfortunately” manifest itself with unconsciousness in the case of alcohol poisoning, as is usually the case with loud choking sounds: Rather, the vomit flows slowly out of the mouth and is only noticed when the patient gasps for air reflexively because the airways are blocked. For laypersons and first-aiders, the only mistake that can be made at this moment is to do nothing at all, because then the patient will die with a high degree of certainty. The aim is to let the vomit flow out of the mouth from the trachea and oesophagus.

To do this, the body is placed as low as possible with the head to create a natural gradient. A pat on the back can accelerate the flow. However, it is not recommended to put a hand or finger in the mouth of the person affected, because of the danger to oneself. It is also important to keep the patient warm, as he or she is no longer able to do this. It should be remembered that even outside temperatures of 30 degrees Celsius are still 7 degrees below the physiological body temperature and can therefore cause severe hypothermia.