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Alcohol Poisoning

By: S. Rennie, LPN

Alcohol poisoning is from acute toxic effects of alcohol consumption. Directly impacting the Central Nervous System, it slows breathing, heart rate, gag reflex, cause gastritis and severe gastrointestinal bleeding to respiratory arrest and death.^1,2 When the gag reflex is slowed, there is danger of asphyxiation. This occurs when the person is unconscious from excessive alcohol intake vomits and then chokes.

A common cause of alcohol poisoning is binge drinking (for women, 4 or more drinks in a short period of time; men, 5 or more drinks in a short period of time.) It can also come from intentionally or accidentally ingesting products that contain alcohol.

• Ethyl alcohol (ethanol) is found in alcohol, mouthwash, perfumes, medications and cleaning agents.
• Isopropyl alcohol (isopropanol) is found in rubbing alcohols, lotions, some sanitizing gels or liquids, antifreeze and some cleaning solvents.
• Methyl alcohol (methanol also known as wood alcohol) is found in paints, varnish, anti-freeze, window washer fluid and some solvents.²

Blood Alcohol Concentration (BAC) is the proportion of alcohol to blood measured in deciliters of blood, i.e., 0.10 grams per deciliter.³ 0.08 is the National legal limit in the United States to operate a motor vehicle.

BAC is affected by how strong the alcohol is, how quickly and in what quantities it is consumed and the amount of food in the stomach. Average elimination of 12 ounces of beer is about an hour. Therefore drinking more alcohol in that hour raises BAC. Binge drinking can raise it the point of poisoning.² BAC also continues to increase after one has stopped drinking or passes out because the alcohol left in the stomach continues to process to the bloodstream.^2,4

An average 160-pound male will have a BAC of approximately 0.04 percent 1 hour after consuming two standard alcoholic beverages on an empty stomach.³ That same man could reach a BAC level beyond 0.40 grams/deciliter by having 20 alcoholic drinks in an hour. Studies have estimated that .050 grams/deciliter is considered lethal, but tolerance variations of BAC levels have also been observed.⁵ (A standard drink is 13.7 grams (1.2 tablespoons) of pure alcohol or 12 ounces of beer; 8 ounces of malt liquor, 5 ounces of wine and 1.5 ounces (a shot) of 80-proof distilled spirits or liquor.⁶

Signs of alcohol poisoning include:^2,4

• Confusion, stupor,
• Unconsciousness
• Vomiting
• Seizures
• Breathing slows to less than 8 breaths per minute
• Irregular breathing
• Hypothermia (low body temperature)

Not all signs need be present before seeking medical attention. If alcohol poisoning is suspected, call 911. An unconscious person should not be left alone, attempting to make the person vomit could lead to choking or accidental aspiration – breathing vomit into the lungs – and cause deadly lung damage.^2,4

Treatment of alcohol poisoning includes, but not limited to:

• Monitoring
• Oxygen therapy
• IV fluids to prevent dehydration
• Kidney dialysis if methanol was ingested or in severe cases of isopropyl alcohol poisoning

Once the patient passes 24 hours, the prognosis is usually a good one.