What is the management of ethanol (alcohol) toxicity?

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From the Research

The management of alcohol poisoning requires immediate medical attention, and the most effective treatment approach is supportive care, including monitoring vital signs, maintaining airway patency, and administering intravenous fluids, as well as considering the use of fomepizole or metadoxine in specific cases, as recommended by the most recent study 1. While waiting for help, it is crucial to keep the person awake if possible and in a sitting position to prevent choking. If they're unconscious, placing them in the recovery position (on their side) can help prevent aspiration of vomit. It is essential not to leave them alone, give them more alcohol, coffee, or food, or try to make them vomit. Medical professionals will provide supportive care, which may include:

  • Monitoring vital signs
  • Maintaining airway patency
  • Administering intravenous fluids to prevent dehydration and correct electrolyte imbalances
  • Oxygen therapy if blood oxygen levels are low
  • Intubation in severe cases to protect the airway
  • Administering thiamine (100mg IV) to prevent Wernicke's encephalopathy, particularly in chronic alcoholics
  • Glucose (D50W, 50mL IV) if hypoglycemia is present, but always after thiamine to prevent precipitating Wernicke's In extreme cases, hemodialysis might be used to rapidly remove alcohol from the bloodstream, as noted in studies such as 2. Alcohol poisoning is dangerous because excessive alcohol depresses the central nervous system, potentially leading to respiratory depression, hypothermia, cardiac arrhythmias, and death. The use of fomepizole, as discussed in 2, or metadoxine, as mentioned in 1 and 3, may be considered in the treatment of alcohol poisoning, but the decision should be based on the most recent and highest-quality evidence available.

References

Research

Identification and management of acute alcohol intoxication.

European journal of internal medicine, 2023

Research

Acute alcohol intoxication.

European journal of internal medicine, 2008

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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