The fact that alcoholism is a disease no one doubts. The treatment of alcoholism is long and difficult. Alcoholics die from the diseases to which this addiction or from accidents leads, through negligence. One of the complications of drinking is alcohol coma.
Worst of all, alcoholic coma can occur not only against the background of alcoholism, because the toxic effect of alcohol can cause the development of coma in a little drinker or in a person who drinks only on holidays. Let's look at why alcohol coma occurs, what is it?
Causes of alcohol coma
Ethanol or alcohol, affecting the human body, causes alcohol poisoning. Despite the fact that many believe that alcohol can improve mood, it is relaxing - this is only the first phase of the action of alcohol. Then drowsiness, indifference, and later brain functions that provide vital processes in the body, are depressed.
Alcohol coma can occur if the alcohol content in the blood is 3%, this corresponds to severe alcohol poisoning. In some cases, even 300–500 ml drunk in a short period of time can lead to an alcoholic coma. Alcohol is easily absorbed by the mucous membranes, a fifth of the drunk dose enters the blood from the stomach, the rest is gradually absorbed in the intestine.
The development of severe alcohol poisoning contributes to:
- lack of food in the stomach (you can not drink alcohol on an empty stomach);
- the amount of alcohol consumed (small doses of alcohol are eliminated through sweat, urine, and respiration, their 90% are decomposed in the liver);
- alcohol drink strength (alcohol content is higher in strong drinks, but drinks with a strength up to 30% are absorbed faster into the blood).
Alcohol coma develops if the amount of alcohol in the blood is 0.3–0.7 (ppm), and this is less than 0.5 liters of 96% alcohol, drunk in a short period of time, a person of normal constitution. Alcohol death occurs when the blood contains 5-8 g / l of ethanol.
Of course, the reaction to drinking alcohol is different for all people, and these are the most common indicators. There are people who have alcoholic coma and comes with a smaller amount of ethanol in the blood, while others should have a larger dose. In addition, dense, fatty foods slow down the absorption into the blood and alcohol is eliminated earlier than its concentration reaches lethal.
What is alcohol coma? How to determine that a person develops coma? Alcohol coma is a state when, against the background of drinking alcohol, a person has a loss of consciousness, he does not recover even with a strong sound (cry), slaps, and the smell of ammonia.
With alcoholic coma, the symptoms change as you get deeper. There are 3 stages of coma.
- The initial stage of development of alcohol coma. Consciousness is absent, a person can make some movements in the limbs, but they are irregular. Sometimes involuntary contractions of the muscles are observed, including smooth muscles of the stomach (vomiting), bladder (involuntary urination). The skin of the face is purple, or bluish. Pupils are narrowed, but there is a reaction to light, sometimes there are floating movements. Respiration is frequent, but hoarse, due to increased salivation and mucus. The pressure is normal or slightly elevated, the pulse is frequent.
- The average stage of development of alcohol coma. Excitement decreases, the patient's muscles relax. The pressure decreases, the bullet becomes slow, weak. Pupils do not respond to light. Breathing slows down, becomes superficial. Often there is discharge of feces and urine.
- Deep stage of development of alcoholic coma. It is characterized by even greater respiratory depression, it becomes rare, disturbed rhythm, pause. This reduces the supply of oxygen to the tissues, and the face becomes bluish. The patient is pale, the limbs are cyanotic (bluish), there is sticky sweat. This is due to the slowing of the heart, the pulse is poorly palpable threadlike, the pressure drops. Impaired blood supply to the organs can lead to changes in the kidneys. Urine becomes dark, brown, bloody. This is a symptom of the development of acute renal failure (ARF). But more often the cause of death in this stage is acute heart or respiratory failure.
If you find a person with signs of alcohol coma on the street, you should immediately call an ambulance! Signs of an alcoholic coma: lack of consciousness, no reaction to the sound, slaps, pupils and the smell of alcohol from the mouth.
The first symptoms of the onset of alcohol coma
When an alcoholic coma develops before your eyes, then you can see that after taking a certain dose of alcohol, the person begins to feel dizzy, he is disoriented, does not always understand where he is, confuses the location of the rooms in a familiar place, and cannot find the necessary items. A pale face, weakness, lengthened pupils, muscle twitches or cramps are the first signs of an onset of alcohol coma.
If at this time to help him empty his stomach, causing vomiting, give 5-6 tablets of activated charcoal and lay on the side, then coma may not be. The man will sleep off. In the morning, of course, will suffer greatly from a hangover. He will have a headache, diarrhea and other dyspeptic phenomena (vomiting, nausea, heartburn) may occur. If there are no breathing and heart problems, then this condition can be treated at home. It is necessary to provide the patient with rest, as strong sounds, light can cause irritation and headache. It is necessary to establish a drinking regime - drink plenty of water, juices, mineral water, in order to quickly remove the products of alcohol exchange from the body. You can drink pain medicine.
When the patient fainted and does not respond to others, then immediately call an ambulance! Of course, the initial stage of alcohol coma often passes on its own, but it is not worth the risk. How long does an alcoholic coma last if there is no disturbance of the heart and breathing? - easy to answer - no more than 6 hours. If during this time the patient's response to the environment has not changed, the coma has already passed into the second stage, and intensive therapy is required. This is a dangerous condition, so you should not wait for a spontaneous exit from a coma, you need to call an ambulance at the first sign.
What to do before the arrival of the ambulance? The main danger in the development of alcohol coma is respiratory failure due to aspiration (ingestion of mucus or vomit in the respiratory tract) or because of sinking of the tongue, which blocks the entrance to the larynx and interferes with the flow of air into the lungs. Therefore, if there are signs of alcoholic coma, emergency first aid includes the following steps.
- It is necessary to lay the patient on the left side. For his position to be stable, he must stretch his left arm forward and bend his leg at the knee.
- Clean the mouth of vomit. This can be done with the index finger wrapped around a piece of cloth, if there is no clamp and gauze pads on hand.
- Excess mucus or vomit in the nasal passages, doctors ambulance removed by suction, but at home an ordinary syringe will help.
- In order not to sink the tongue, you can throw back your head and push the lower jaw forward. To do this, press with your thumbs on the corners of the mandible, and with index fingers they press on the chin, opening the mouth. Ambulance doctors can use a tongue holder or special air ducts for this.
- When a patient has convulsions, you need to hold him so that he does not hit against closely located pieces of furniture.
First aid for alcoholic coma helps to avoid such complications as aspiration pneumonia. This is a dangerous condition caused by ingestion of stomach contents during vomiting in the lungs.
There is also another complication - laryngospasm, when, against the background of irritation with vomiting, the vocal cords are sharply compressed, and the patient cannot breathe. In such a situation, an urgent tracheal intubation may be necessary - a tracheotomy (an incision is made in the skin, subcutaneous tissue and trachea to form a hole with the external environment through which air will flow). This can only be done by a specialist.
Alcohol coma has the ICD code 10 - T51, which means that it is considered a separate disease according to the international classification of diseases.
In order to remove a person from an alcoholic coma, the following therapeutic measures are necessary.
Wash the stomach with a gastric tube to clean water. Flushing the stomach at home, without a probe, is unacceptable, it can lead to aspiration.
- Conduct intensive therapy by intravenous physiological and 5% glucose solutions in a volume of 1.5-2 liters. It is also shown the introduction of a 4% solution of sodium bicarbonate, which will reduce the acidity of the blood. It rises because of the products of the exchange of alcohol.
- For quick removal of water from the body, diuretics are injected ("Furosemide"), you must first put a catheter in the bladder to monitor the amount of fluid injected and excreted. This is important to do, since alcohol coma is accompanied by hypoxia of the brain (lack of oxygen), which can cause brain edema with serious impairment of brain activity. Therefore, against the background of intensive administration of solutions, osmotic preparations are used ("Mannitol").
- The administration of atropine helps to reduce excessive saliva and mucus in the lungs, and also supports the functioning of the heart, preventing slow pulse (bradycardia). The appearance of bradycardia speaks of the deepening of alcoholic coma.
- The drop in blood pressure can be adjusted by vascular means or hormonal drugs.
- Since alcohol poisoning products of the decay of ethanol, adversely affect the cells of the nervous system, injected B vitamins, vitamin C, nicotinic acid.
- If there are problems with breathing, or the patient had aspiration of vomitus, intubation (insertion of the endotracheal tube into the trachea), cleansing of the pulmonary trunk and bronchi with a bronchoscope or suction and artificial ventilation of the lungs are indicated. Then the patient is prescribed a course of antibiotics to prevent pneumonia.
Consequences of alcohol coma
With timely adequate treatment, the patient leaves the alcoholic coma within 2-4 hours. But even with a favorable course of alcoholic coma causes consequences in the form of bruises and injuries during a fall, headache, memory impairment. Some of the effects of alcohol coma can lead to a worsening of the patient’s condition and death.
Acute renal failure. Occurs with prolonged squeezing of the muscles, under the weight of the body. Myoglobin, which is contained in them, is destroyed and excreted by the kidneys, clogging their tubules. This leads to the arrester. Therefore, a person in an alcoholic coma cannot be left in the same posture for a long time;
- Inflammation of the lung against the background of aspiration. The aggressive effect of gastric juice, can cause the destruction of the lung tissue, and the accession of infection significantly worsens the prognosis.
- The destruction of the cells of the cerebral cortex on the background of alcohol intoxication can lead to a decrease in mental abilities or dementia.
Alcohol coma is a dangerous condition that can lead to death. At the first signs of a coma, call an ambulance, only provided timely medical care can save a person’s life.