Poisoning with alcohol substitutes
Poisoning with alcohol substitutes takes a leading position in the statistics of all intoxications. Moreover, 98% of patients die before hospitalization. A brief description of the alcoholic surrogate will help to understand the reason for such a high mortality.
What are alcohol substitutes? What are the signs of poisoning such an alcohol imitation? How to help the victim? What could be the consequences of such intoxication? The answers to these questions we will discuss in this article.
What is related to alcohol substitutes
Poisoning with alcohol substitutes in the International Classification of Diseases ICD-10 correspond to codes T51.1 - T52.9.
They are divided into two groups: those substitutes for alcohol, which may contain ethyl alcohol, and those that can be without it. The first group includes:
- Butyl alcohol. Death occurs after taking only 30 milliliters.
- Hydrolytic and sulphite alcohols, which are obtained from wood. They are more toxic than ethanol due to the presence in the composition of a small amount of methyl alcohol.
- Denatured alcohol or technical alcohol. Contains some wood alcohol and aldehyde.
- Colognes and lotions. Their composition can include up to 60% ethanol.
- The polish contains several types of toxic alcohols.
- The stain with ethanol has dyes, from which the skin and mucous membranes of the patient become blue in color.
The second group or else they are called “false surrogates” is represented:
- methyl alcohol;
- ethylene glycol.
Clinical symptoms of alcohol substitutes poisoning
The symptoms of alcohol substitutes poisoning differ depending on which group they belong to. They will be more favorable if they are alcohol substitutes of the first group containing ethyl alcohol, and more severe and dangerous in case of poisoning with methanol or ethylene glycol, so they should be discussed in more detail.
Symptoms of poisoning with substitutes containing ethyl alcohol
Clinically observed first signs of intoxication:
- emotional and motor stimulation;
- redness of the face;
- state of euphoria;
- increased salivation;
- feeling of mental and physical relaxation.
Then intoxication gives way to symptoms of alcohol intoxication. The skin becomes pale. There are frequent urge to urinate. Pupils dilate, mouth feels dry. Increased mental and physical activity is accompanied by a lack of coordination, movements become sweeping. There is a reduced concentration of attention, speech is slurred. Sharply reduced or completely absent criticism of their words and actions.
Symptoms of methanol poisoning (wood alcohol)
Methyl alcohol is rapidly absorbed in the digestive system. About 75% of the absorbed poison is excreted with breathing, the rest - with urine. The lethal dose ranges from 50 to 150 milliliters. The brunt of poisoning is on the nervous system and kidneys. There is a psychotropic effect (pathological changes in the psyche) and a neurotoxic effect, including, among other things, damage to the optic nerves and retina.
So, in case of poisoning with alcohol substitutes containing methanol, the following symptoms occur:
- nausea, vomiting;
- intoxication and euphoria are mild;
- blurred vision: flickering of black spots before eyes, blurred vision, diplopia (double vision) and even blindness;
- externally in such patients the pupils are dilated, sluggishly react to light;
- 1-2 days after poisoning, there are pains in the abdomen, lower back, aching muscles and joints;
- temperature rises to 38⁰;
- dry skin and mucous membranes;
- low blood pressure;
- interruptions in the work of the heart;
- bouts of excitement, accompanied by cramps;
- as the symptoms increase, the victim falls into a coma, paralysis of the limbs develops.
Symptoms of ethylene glycol poisoning
Ethylene glycol is also rapidly absorbed in the digestive tract. About 60% of the poison is broken down in the liver, about 20–30% is excreted by the kidneys. Therefore, it is these organs that will suffer the most, up to the development of their acute insufficiency. With severe poisoning, there are signs of damage to the nervous system.
When intoxicated with this alcohol surrogate, symptoms develop over periods.
- Early period. It lasts about 12 hours and is characterized by signs of intoxication with good health.
- Toxic damage to the nervous system. It is noted: nausea, vomiting, headache, thirst, diarrhea, skin and mucous membranes become bluish. Pupils are dilated, body temperature rises, breathing becomes difficult, tachycardia, psychomotor agitation. Consciousness is possible with the development of seizures.
- The nephro and hepatotoxic period develops 2–5 days from the onset of the disease. There is a clinic of hepatic and renal failure. Appears yellowness of the skin, which appears first on the sclera and in the last turn yellow palms. Itching is characteristic, dark urine may occur. Renal failure is manifested by a decrease in diuresis up to its absence.
Emergency care for alcohol substitutes poisoning
If you suspect poisoning by alcohol substitutes, emergency care will depend on the initial condition of the patient. If the patient is unconscious, then it should be laid on a flat hard surface, turn his head to the side so that there is no aspiration of vomit and call an ambulance. When respiratory and cardiac disorders are abnormal, first they call an ambulance, and then they carry out an indirect heart massage and artificial respiration.
When the victim in the mind of the first pre-medical care consists of the following:
- take a sorbent;
- saline laxative;
- drink enveloping decoction, for example, jelly;
- emergency hospitalization in the hospital.
Treatment of poisoning by alcohol substitutes in the hospital:
- Gastric lavage through the probe. When intoxicated with methanol, it is repeated for 3 days. Give sorbents.
- The antidote treatment is the same in both cases: a 5% ethanol is injected intravenously. In case of mild poisoning, 30% ethyl alcohol is allowed inside.
- In case of ethylene glycol poisoning, calcium gluconate is injected to neutralize the decomposition products of the toxic substance.
- The forced diuresis, which is based on the drip of a large number of solutions and diuretic drugs in the absence of renal dysfunction, is carried out.
- Removal of toxins from the blood is also carried out by hemodialysis.
- The introduction of glucose with novocaine, prednisone, and vitamins of groups B and C is carried out.
- In case of methanol poisoning, spinal punctures are performed.
- In severe cases of ethylene glycol toxicity, a kidney transplant may be necessary.
Consequences of alcohol poisoning
Although the course of poisoning with alcohol substitutes containing ethanol is more favorable, the consequences can be very serious. The forecast is determined by the number of drunk forgeries, and more by the timeliness of medical care provided. If the patient suffered from chronic alcoholism, the poisoning is more severe and there are more deaths than those who did not have alcohol dependence.
In case of methanol intoxication, complete loss of vision is possible, which after removal of the poison from the body is not restored. Ethylene glycol based surrogates cause kidney failure. Such patients mostly die.
The problem of poisoning with alcohol substitutes, unfortunately, remains relevant today. Many are faced with this disease, so knowing the signs of such intoxications will help not only to provide emergency assistance to the victim in a timely manner, but also to save his life!