Ethanol Toxicity
The greatest risk to anyone who drinks alcohol is the stock-standard pissed-as-a-newt high school student style of alcohol poisoning. It tends to come from our culture of binge drinking, rather than the more moderate consumption sometimes observed in Europe. Jack has the details ...
The fatal dose of ethanol is 300-400 mL of pure ethanol (600-800 mL of 50%
spirits), for the average adult if consumed in less than one hour.
Chronic users develop a tolerance to ethanol. Ethanol depresses the central nervous
system irregularly in descending order from cortex to medulla, depending on
the amount ingested. The range between a dose that produces anesthesia and
one that impairs vital functions is small. Thus, an amount that produces
stupor is dangerously close to a fatal dose. Effects are potentiated by
concomitant ingestion of barbiturates and other depressant drugs.
Intoxication levels (broadly) are found in this manner:
- Mild (Blood alc content 0.05%-0.15% - one fourth of the people at this level are clinically
intoxicated) results in decreased inhibition, slight visual imparement,
muscular incoordination, and slowed reaction time.
- Moderate: (BAC: 0.15%-0.3% - 50 to 95% of the people at this level are clinically intoxicated)-
results in definite visual imparement, sensory loss, muscular incoordination,
slurring of speech.
- Severe (BAC 0.3%-0.5% -fatalities begin to occur in this range)-marked
muscular incoordination, blurred vision, approaching stupor.
- Coma (BAC above 0.5% - death is common in this range)- Unconsciousness, slowed respiration,
complete loss of sensations.
Treatment of acute poisoning begins with the
removal of unabsorbed ethanol by gastric lavage with tap water or by emesis
(induced vomitting). The airway must be kept clear- artificial respiration
may be needed. Give 2grams of sodium bicarbonate in 250ml of tap water every
2 hours to maintain neutral or slightly alkaline urine, avoid administration
of excess fluids. Avoid all depressant drugs. In the presence of
hypoglycemia, give 5-10% glucose intravenously plus thiamine, 100mg
intramuscularly. Hemodialysis is needed if the blood ethanol level is above
5mg/ml. Survival for 24 hours is ordinarily followed by recovery.
I know
most of the readers of this website are responsible enough to not need this
information, but we just had another college student have a "21 drinks for
21 years" birthday party, and it killed him.
