Sharp alcoholic intoxication
Sharp alcoholic intoxication (alcoholic intoxication) – a complex of violations of behavior, the psychological and physiological reactions arising after alcohol intake. Develops owing to toxic effect of ethanol and products of his metabolism. It is shown by euphoria, an incoordination of movements, attentiveness loss, decrease in criticism to own opportunities and a state. At increase in a dose the people who do not have alcoholism have a nausea and vomiting. At heavy degree of intoxication breath and blood circulation is broken. Disorders of consciousness up to a coma are possible. Treatment – a detoxication, symptomatic therapy.
Sharp alcoholic intoxication
Sharp alcoholic intoxication (alcoholic intoxication) – often found state, it can be observed both at alcoholics, and at the people who are not suffering from alcoholic dependence. Alcoholic intoxication is a medical, social and legal problem. Drunk participate in criminal incidents more often, get into accident, become the victims of accidents in life and on production. A considerable part of the patients asking for the help traumatologists at the time of a trauma was in alcohol intoxication.
Alcoholic intoxication increases risk of an aggravation of a number of chronic diseases and emergence of sharp states which quite often pose hazard to life of the patient. Mellori-Weiss's syndrome, sharp pancreatitis, hypertensive crisis, a stroke, arrhythmia, IBS, a myocardial infarction etc. are among such states. After long stay in a condition of intoxication (in hard drinking) at patients with alcoholic dependence the alcoholic depression and alcoholic deliriya can develop. Treatment of intoxication is performed by experts in the field of narcology. In hard cases participation of resuscitators is required.
Reasons and classification of sharp alcoholic intoxication
Impact of ethanol and products of his metabolism on the patient's organism is an immediate cause of alcoholic intoxication. At the same time the leading role is played by features of reaction of TsNS. In the beginning alcohol has exciting effect on a cerebral cortex, then excitement is replaced by braking, subcrustal educations get out of the control of bark. At increase in concentration of ethanol in blood processes of braking extend to subcrustal educations, a cerebellum and a medulla.
Distribution of braking on various structures of TsNS can be monitored, having divided signs of alcoholic intoxication into mental, neurologic and vegetative violations. At the use of a small amount of ethanol first of all mental functions (braking of a cerebral cortex) suffer. At increase in a dose there are more and more noticeable neurologic frustration. At heavy intoxication mental activity stops practically, observed oppression of the vital vegetative functions.
Weight of intoxication first of all is defined by amount of the ethanol coming to blood, that is, quantity and fortress of alcoholic drink. Expressiveness of intoxication increases at reception of low-quality alcohol ("fake" vodka, denatured alcohol, technical and medical alcohol-containing liquids which are not intended for the internal use). Along with listed, weight of intoxication is influenced by time during which alcohol came to an organism.
The body weight of the patient, time of day, quality and amount of food (on an empty stomach intoxication comes quicker, at the use of food, especially fat – more slowly), conditions in the room matters (in hot and stuffy rooms of people gets drunk quicker, on cold – more slowly, upon transition from cold during a heat of the phenomenon of intoxication amplify). A lot of things depend on individual reaction of the patient changing depending on his physical and psychological state.
The same symptoms of sharp alcoholic intoxication are shown differently at patients with various personal features (type of nervous system, level of education and the general culture of behavior etc.). The susceptibility to alcohol raises at a physical and emotional overstrain, mental diseases and some psychological violations, somatic and infectious diseases, the general exhaustion, and also after the postponed craniocereberal injuries.
Distinguish three degrees and three types of sharp alcoholic intoxication. On weight allocate easy, average and heavy degree of alcoholic intoxication, on type – simple (typical), atypical and pathological intoxication. Atypical intoxication is more often observed at chronic alcoholism, can arise at craniocereberal injuries, mental violations etc. Pathological intoxication – seldom found state which does not depend on existence or absence of alcoholism and a dose of alcohol.
Symptoms of simple (typical) sharp alcoholic intoxication
Simple alcoholic intoxication is usually observed at the people who are not suffering from alcoholic dependence. At easy alcoholic intoxication raising of mood, satisfaction, feeling of internal and external comfort, desire to contact to other people prevails. All manifestations are exaggerated, a little exaggerated: speech loud and bystry, mimicry very active, movements wide. Some deterioration in accuracy of movements, absent-mindedness of attention and a sexual rastormozhennost is noted. The person is hyperemic, pulse is speeded up, appetite is increased. 2-3 hours later euphoria is replaced by drowsiness, slackness and block. In the subsequent the person well remembers everything that occurred during reception of alcoholic drinks.
At average degree of intoxication euphoria remains, however the mood becomes more unstable. Fun can quickly be replaced by embitternment, complacency – irritation, an arrangement to the interlocutor – an aggression attack. To the forefront there are neurologic frustration: the muffled speech, illegible handwriting, the expressed static and dynamic ataxy. The people who do not have alcoholism often have a nausea and vomiting. Patients are guided in surrounding, however switching of attention represents considerable difficulties. After a while there comes the deep sleep. When awakening patients feel a headache, weakness, slackness, weakness. At the low-drinking people of reminiscence are kept, but are foggy. Alcoholics often have memory blackouts.
Heavy alcoholic intoxication is followed by the progressing consciousness violations. Devocalization is replaced by a sopor. In hard cases there is a coma. The productive contact is almost impossible, the patient illegibly mutters something or does not react to surrounding. The mimicry is poor. Because of gross violations of coordination of movements of the patient cannot stand, sit and carry out the simple movements. The incontience of urine and a calla is possible. After a while the patient fills up with a deep dream from which he cannot be brought, even using liquid ammonia. Aspiration of emetic masses is possible. In coma pupils of the patient do not react to light, pulse is weakened, breath is complicated. After getting out of alcohol intoxication deterioration in appetite and a sharp adynamy is observed. The patient does not remember what occurred during reception of alcoholic drinks.
Atypical sharp alcoholic intoxication
Disforichesky intoxication can be observed after craniocereberal injuries, at epilepsy and some psikhopatiya. Irritability, gloom and rage prevails. Aggression and an autoaggression is possible. Sharp decrease in mood, a hopelessness and tendency to self-flagellation is characteristic of the depressive intoxication arising at an endogenous and psychogenic depression. The movements and the speech are slowed down, on this background the sudden surges in activity which are followed by suicide actions can be observed.
Somnolentny intoxication develops at an adynamy and the general exhaustion, the use of ethanol in combination with clonidine and tranquilizers. Euphoria is almost not expressed or is absent. The patient quickly sinks into a deep sleep which can pass in soporozny and coma. Hysterical intoxication is observed at patients of isteroidny type, is followed by rough expressivity and theatricality of behavior. The patient as if plays a performance before people around. At the choice of the "tragic" scenario suicide attempts, as a rule, not posing real hazard to life of the patient are possible.
Treatment and the forecast at sharp alcoholic intoxication
Tactics of treatment is defined by weight of intoxication and the general condition of the patient. At intoxication of easy degree medical care is not required. At intoxication of average and heavy degree perform dezintoksikatsionny and symptomatic therapy. Carry out washing of a stomach – the patient is given the crushed absorbent carbon, and then delete gastric contents via the probe or cause vomiting, pressing on a language root. Infusional therapy is appointed both for a detoxication, and for restoration of water and electrolytic and acid-base balance.
With salt solutions and glucose add vitamins to droppers. Carry out the symptomatic treatment directed to maintenance and normalization of the vital functions: mocheotdeleniye, warm activity, pressure, breath, blood circulation etc. At a serious poisoning apply a technique of the forced diuresis and hyperbaric oxygenation. If necessary carry out a kateterization of a bladder, transfer patients to IVL.
In case of development of sharp alcoholic intoxication in the persons having alcoholism transportation of the patient in narcological clinic for passing of a course of hospitalization of alcoholism by it under observation of the narcologist is possible.
Forecast in most cases favorable. At easy and average intoxication the residual phenomena disappear within a day, at heavy weakness within several days is possible. The forecast worsens at development of medical emergencies, the sharp and chronic diseases caused by alcohol intake. Especially often complications arise at an alcoholic coma, the miorenalny syndrome, toxic hepatitis, a sharp cardiovascular, respiratory and liver failure is possible.