Alcoholic coma - severe poisoning with ethyl alcohol, accompanied by a loss of response to external stimuli, oppression of respiratory, nerve centers, a violation of thermoregulation.
Alcohol coma
The meaning of the word "coma" in Greek is "sleep, slumber."The modern medical term "alcoholic coma" has little to do with drowsiness.
In a state of alcoholic coma, the swallowing, cough reflex is broken, the tone of muscles controlling the movement of the tongue is weakened. This creates dangerous conditions when the patient can not cough up saliva, vomit, trapped in the trachea.
Alcoholic coma is accompanied by respiratory depression, reduced ventilation of the lungs. These signs can develop not only in patients suffering from alcoholism. A life-threatening condition can occur in a completely non-drinking person who first tried alcohol.
Reasons for
Approximate concentration of alcohol in the blood, capable of provoking someone, is 3 g / l. When this value is increased to 5 g / l, the likelihood of a lethal outcome increases manyfold.
Action on the brain
The main cause of alcohol coma is the neurotoxic effect of ethyl alcohol on the brain. The initial excitation caused by the action of ethanol, is replaced by inhibition of the respiratory center, the centers responsible for the autonomic nervous system, thermoregulation.
Hypovolemia
Ethyl alcohol causes swelling of the tissues, leading to hypovolemia - a condition in which the total volume of blood decreases due to loss of fluid in the body. Hypovolemia is expressed in muscle cramps, weakness, lowering of temperature.
These disorders cause a decrease in blood pressure, an increase in the viscosity of the blood. The patient has pain in the abdomen, heart area, he loses consciousness.
OPINION OF SPECIALISTS!
Elena Malysheva:
"Is Alcoholism Cured? Yes! Use an effective home remedy. .. "
Read more. ..
Hypoglycemia
Alcohol intake causes a change in the amount of glucose in the blood. Reducing the concentration of sugar arises due to the fact that the cleavage of the molecule of ethyl alcohol consumes the enzyme necessary to maintain glycogen stores in the liver.
Call out to whom, when consuming alcohol, a sharp drop in blood glucose is possible. Such a state can develop not only with the intake of strong drinks, but also with the use of wine, beer by teenagers.
Ethanol enhances insulin activity, accelerating the reduction of blood sugar, accelerating the development of hypoglycemic alcohol coma( in 15% of cases).Hypoglycemia provokes the patient's stay in the cold. This is due to the increase in glucose consumption for thermoregulation.
Stages of
Acute alcohol intoxication is accompanied by disruption of the work of nerve centers, loss of ability to respond to events, loss of consciousness and coma. A coma can develop with a blood alcohol concentration of 3 ppm.
This condition is life threatening, in its development there are three stages.
Superficial coma of the 1st degree
For this stage, the following characteristics are characteristic:
- Pupils narrowed;
- mimicry is broken;
- there is a reaction to light;
- preserves protective reactions to the inhalation of ammonia.
After washing the stomach at this stage of coma, a person comes to life. Uncomplicated superficial coma lasts up to 6 hours. This stage is called resorption. Ethanol is absorbed by the cells of the body, begins its destructive activity.
Superficial coma of 2nd degree
The second degree of alcoholic coma has such characteristic symptoms:
- Muscle tone is relaxed;
- protective reaction to the inhalation of vapors of ammonia is almost not manifested;
- is not restored after gastric lavage.
In coma of stage 2, the ethanol content in the victim's blood reaches 6.5 ppm. How many days does this state continue? The superficial coma of the 2nd degree lasts only 12 hours, corresponds to the elimination phase, at which the alcohol gradually splits in the body, and its concentration decreases.
Deep coma
To distinguish between the deep to whom the patient will benefit from such signs:
- Muscular reflexes are absent;
- pain reaction, tactile absent;
- no reaction to inhalation of ammonia;
- there is no reaction to light;
- pupils narrowed;
- breathing is disturbed;
- may cause seizures.
The alcohol content of the blood at stage 3 of the alcoholic coma reaches 7.5 ppm.
Progression of the coma in the first stage is quite possible to stop on its own. The victim of alcohol poisoning should be washed stomach so that his condition is restored.
At a coma of the second stage, others are no longer able to help the patient. He needs emergency hospitalization. At the third stage of the coma, the patient must be taken to the toxicology department and provided assistance.
Symptoms of
The first symptoms of a progressive alcoholic coma are manifested by changes in reflexes, sensory organs, respiratory system, and loss of consciousness. With a superficial coma of the 1st degree, the patient is impaired the functions of the nerve centers of the cerebral cortex, pain sensitivity decreases, salivation increases, the sphincters of the urethra relax.
Alcohol poisoning causes the heart to beat faster, but the blood pressure does not exceed the usual values. At breath of the victim rattles are audible, there is a dyspnea or short wind.
With superficial coma, there is an increase in muscle tone of the limbs, masticatory muscles. The jaw of the patient reduces so that he can not speak, has difficulty breathing.
For a surface alcoholic coma of grade 2, there is a lack of muscle tone, an increase in blood pressure. The patient's breathing is weakened, it becomes frequent, superficial. The pulse is increased to 100 beats per minute.
The temperature drops to 35 0C, the pulse is rare, threadlike, blood filling is reduced due to lowering of blood pressure. The respiratory function suffers, water-salt balance is broken, signs of heart failure, dehydration increase.
First aid
If a patient has signs of superficial coma, he needs to immediately call an ambulance. While medical workers have not arrived, relatives of the victim should act independently, to provide the patient with first aid.
With a superficial coma
The victim must be placed on the stomach, turning slightly to the side, the head should hang slightly down. In this position, there is less risk of suffocation.
It is important to remember that alcohol depresses the work of the thermoregulatory center in the brain, the patient's body temperature goes down. To support the body, it is necessary to provide heat - to bring the patient into a warm room, cover with a blanket.
Further, the first medical aid is carried out in the following sequence:
- It is necessary to moisten the tissue with ammonia, bring it to the patient's face and offer a sniff.
- Offer a warm drink to the patient - weak sweet tea, milk.
When alcohol poisoning the body is highly dehydrated, a warm drink is necessary to make up for the lack of liquid, restore the water-electrolyte balance.
In case of severe coma
Deterioration of the condition of the victim from alcohol poisoning is especially dangerous if the patient has lost consciousness, does not react to what is happening, can not swallow independently, does not control reflexes.
Prior to the arrival of emergency specialist care in the absence of breathing, they begin resuscitation measures - they do artificial respiration, indirect heart massage.
First aid for alcohol coma:
Treatment of
The first medical aid for alcoholic coma of a severe degree should be the elimination of alcohol from the body, stopping its absorption from the digestive system into the blood.
To do this, the patient is washed with a stomach through a probe, and then a saline solution containing glucose, insulin, soda, vitamins B1, B6, and C is injected into the vein.
Vitamin C prevents the conversion of ethyl alcohol to acetaldehyde, thereby stopping the intake of ethanol into the body.
To reduce salivation, the patient is given an injection of atropine, this will help to prevent the saliva from flowing into the trachea. To support the work of the heart, the patient is administered caffeine.
The patient is repeatedly rinsed with a nasogastric tube. Then activated carbon is injected through the probe to adsorb toxins contained in the stomach.
Patients are assigned glucose, vitamin B1 to prevent hypovitaminosis, preparations for restoring the tone of blood vessels and heart, after exiting the coma.
Recovery period
After a coma lasting no more than 6 hours, the patient has a chance to restore health, with refusal, of course, from taking alcohol in the future.
If the alcoholic coma lasted more than 12 hours, the forecast is complex. Particular attention should be given to the patient to restore the functions of the circulatory system, the heart.
He needs to take vitamin complexes with minerals, restore the water-salt balance, disturbed by dehydration. We need drugs to improve liver function, blood circulation, brain functions.
Cope with the destructive effects of alcohol caused by coma, you can only turn to professionals who can provide a full range of specialized medical care.
Consequences of
One of the severe consequences of alcohol coma is myoglobinuria - the defeat of striated muscles with prolonged compression by the weight of its own body.
Compression of muscles causes the destruction of muscle fibers. Myoglobinuria in my urine shows myoglobin, kidney failure develops, manifested by anemia, hemorrhagic syndrome. In advanced cases, uremia develops.
After exiting from a coma, the victims experience severe pain in their muscles, the surrounding tissues swell and become denser. In the future, degradation, muscle necrosis develops. On the part of the respiratory system after exiting the alcohol coma, pneumonia, tracheobronchitis occur.
And most of all, the central nervous system suffers from an alcoholic coma. The consequences of a coma for the cerebral cortex are simply catastrophic. After an alcoholic coma, the degradation of the personality is almost inevitable.