Alcoholic comatose. Alcoholic coma - concept, medical care, causes and consequences. Reasons for the development of alcoholic coma

Alcoholic coma- severe poisoning ethyl alcohol accompanied by a loss of response to external stimuli, depression of the respiratory, nerve centers, violation of thermoregulation.

Alcoholic coma

The meaning of the word "coma" in Greek is "sleep, drowsiness". Modern medical term"alcoholic coma" has little to do with drowsiness.

In a state of alcoholic coma, the swallowing, cough reflex is disturbed, the tone of the muscles that control the movement of the tongue is weakened. This creates dangerous conditions when the patient cannot cough up saliva, vomit that has entered the trachea.

Alcoholic coma is accompanied by respiratory depression, decreased 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 has tried alcohol for the first time.

To develop a coma, it is enough to drink 420 g of vodka. But this figure only reflects the approximate amount of alcohol that can cause a coma. For each person, this number is different, depending on the state of health, work digestive system, age.

The reasons

The approximate concentration of alcohol in the blood that can provoke a coma is 3 g / l. When this value is increased to 5 g/l, the probability lethal outcome increases many times.

Action on the brain

The main cause of alcoholic coma is neuro toxic effect ethyl alcohol on the brain. The initial excitation caused by the action of ethanol is replaced by inhibition of activity respiratory center, centers responsible for the work of the autonomic nervous system, thermoregulation.

Ethyl alcohol causes tissue swelling, leads to hypovolemia - a condition in which, due to fluid loss in the body, the total volume of blood decreases. Hypovolemia is expressed in muscle cramps, weakness, lowering the temperature.

These disturbances cause a decrease blood pressure, increased blood viscosity. The patient develops pain in the abdomen, heart area, he loses consciousness.

hypoglycemia

Drinking alcohol causes a change in the amount of glucose in the blood. The decrease in sugar concentration occurs due to the fact that the breakdown of the ethanol molecule consumes the enzyme necessary to maintain glycogen stores in the liver.

A sharp drop in blood glucose levels can cause a coma when drinking alcohol. Similar state can develop not only when taking strong drinks, but also when drinking wine, beer by teenagers.

Ethanol enhances the activity of insulin, accelerating the decline in blood sugar levels, accelerating the development of hypoglycemic alcoholic coma (in 15% of cases). Hypoglycemia provokes the patient's stay in the cold. This is due to an increase in glucose consumption for thermoregulation.

stages

Acute alcohol intoxication is accompanied by disruption of the nerve centers, loss of the ability to respond to what is happening, loss of consciousness and coma. A coma can develop at a concentration of 3 ppm.

This condition is life threatening and goes through three stages in its development.

Superficial coma 1 degree

This stage is characterized by the following symptoms:

The pupils are constricted;
facial expressions are broken;
there is a reaction to light;
persist defensive reactions inhalation of ammonia.

After washing the stomach at this stage of the coma, the person comes to his senses. 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.

The concentration of ethyl alcohol at this time increases, if it does not exceed 5 ppm, then there is a possibility self exit from a coma. In this case, it is possible to improve the patient's condition without treatment. The amount of alcohol in the blood at this stage corresponds to 4 ppm.

Superficial coma 2 degrees

The second degree of alcoholic coma has the following characteristic symptoms:

Muscle tone is relaxed;
a protective reaction to the inhalation of ammonia vapors is almost not manifested;
after gastric lavage, the condition is not restored.

In stage 2 coma, the ethanol content in the blood of the victim reaches 6.5 ppm. How many days does this state last? A superficial coma of the 2nd degree lasts only 12 hours, corresponds to the elimination phase, in which alcohol is gradually broken down in the body, and its concentration decreases.

deep coma

The following signs will help to distinguish a deep coma in a patient:

Tendon-muscle reflexes are absent;
pain reaction, tactile are absent;
there is no reaction to the inhalation of ammonia;
there is no reaction to light;
pupils are constricted;
breathing is disturbed;
seizures may occur.

The progression of coma in the first stage is quite possible to stop on their own. A victim of alcohol poisoning should flush the stomach so that his condition is restored.

With 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, to provide assistance.

Symptoms

The first symptoms of a progressive alcoholic coma are manifested by changes in reflexes, sensory organs, respiratory system, loss of consciousness. With a superficial coma of the 1st degree, the patient's functions of the nerve centers of the cerebral cortex are disturbed, the pain sensitivity, salivation increases, sphincters of the urethra relax.

Alcohol poisoning makes the heart beat faster, but blood pressure still does not exceed usual values. When the victim breathes, wheezing is heard, shortness of breath appears.

With superficial coma, there is an increase in the tone of the muscles of the limbs, chewing muscles. The patient's jaws are reduced so that he cannot speak, he has difficulty breathing.

Superficial alcoholic coma of the 2nd degree is characterized by the absence muscle tone, increased blood pressure. The patient's breathing is weakened, it becomes frequent, superficial. The pulse quickens to 100 beats per minute.

A symptom of a deep alcoholic coma is a violation of peripheral circulation, an increase in acrocyanosis - insufficiency of capillary circulation. Acrocyanosis is manifested by cyanosis of the skin of the extremities, the nasolabial triangle, and pallor of the face.

The temperature drops to 35 0C, the pulse is rare, thready, blood filling decreases due to a decrease in blood pressure. Suffering respiratory function, violated water-salt balance, signs of heart failure, dehydration are increasing.

First aid

If the patient has signs of a superficial coma, he needs to immediately call " ambulance". Bye medical workers did not arrive, relatives of the victim should act independently, provide first aid to the patient.

With superficial coma

The victim must be placed on his stomach, turning slightly on his side, his head should hang down a little. In this position, there is less risk of suffocation.

It is important to remember that alcohol inhibits the work of the thermoregulation center in the brain, the victim's body temperature drops. To support the body, it is necessary to provide warmth - bring the patient into a warm room, cover with a blanket.

Need to dampen the cloth ammonia, bring to the face of the patient, offer to smell.
Offer to the patient warm drink- weak sweet tea, milk.

With alcohol poisoning, the body is severely dehydrated, a warm drink is necessary to make up for the lack of fluid, restore water and electrolyte balance.

For severe coma

The deterioration of the condition of a victim of alcohol poisoning is of particular danger if the patient has lost consciousness, does not respond to what is happening, cannot swallow independently, and does not control reflexes.

Before the arrival of the emergency specialized care in the absence of breathing, proceed to resuscitation- do artificial respiration, indirect massage hearts.
First aid for alcohol coma:

Treatment

The first medical aid for a severe alcoholic coma should be the removal of alcohol from the body, stopping its absorption from the digestive system into the blood.

To do this, the patient's stomach is washed through a tube, and then injected into a vein saline containing glucose, insulin, soda, vitamins B1, B6, C.

Vitamin C prevents the conversion of ethyl alcohol to acetaldehyde, thus stopping the flow of ethanol into the body.

To reduce salivation, the patient is given an injection of atropine, this will help prevent saliva from flowing into the trachea. To support the work of the heart, the patient is injected with caffeine.

The most important task for removing the victim from the state of alcoholic coma is to restore ventilation of the lungs. To do this, you need to clear oral cavity the patient from vomiting, improve airway patency by extending the head back, applying an oxygen mask.

The patient undergoes repeated gastric lavage using a nasogastric tube. Activated charcoal is then introduced through a probe to adsorb the toxins contained in the stomach.

Patients are prescribed glucose, vitamin B1 to prevent hypovitaminosis, drugs to restore tone blood vessels and heart, after coming out of a coma.

Recovery period

After a coma lasting no more than 6 hours, the patient has a chance to restore health, if, of course, he refuses to take alcohol in the future.

If the alcoholic coma lasted more than 12 hours, the prognosis is difficult. Special attention the patient should be directed to the restoration of functions circulatory system, hearts.

He needs to take vitamin complexes with minerals, restore the water-salt balance, disturbed by dehydration. Drugs are required to improve the functioning of the liver, blood circulation, and brain functions.

deal with destructive action alcohol caused by coma can only be obtained by contacting professionals who can provide a full range of specialized medical care.

Effects

One of severe consequences alcoholic coma is myoglobinuria - damage to striated muscles with prolonged squeezing by weight own body.

Muscle compression causes the destruction of muscle fibers. With myoglobinuria, myoglobin is detected in the urine, renal failure develops, manifested by anemia, hemorrhagic syndrome. AT advanced cases uremia develops.

After coming out of a coma, victims experience severe pain in the pinched muscles, the tissues surrounding them swell and thicken. In the future, degradation, muscle necrosis develops. On the part of the respiratory system, after leaving the alcoholic coma, pneumonia and tracheobronchitis occur.

And most of all, the central nervous system suffers from alcoholic coma. The consequences of a coma for the cerebral cortex are simply catastrophic. After an alcoholic coma, personality degradation is almost inevitable.

There is no doubt that alcoholism is a disease. The treatment of alcoholism is long and complicated. Alcoholics die from diseases that this addiction leads to or from accidents, through negligence. One of the complications that causes the use of alcohol is an alcoholic coma.

The worst thing is that an alcoholic coma can occur not only against the background of alcoholism, because the toxic effect of alcohol can cause the development of a coma in a light drinker or in a person who drinks only on holidays. Let's look at why an alcoholic coma occurs, what is it?

Causes of an alcoholic coma

Ethanol or alcohol, acting on the human body, causes alcohol poisoning. Despite the fact that many people believe that alcohol can improve mood, relaxation is only the first phase of the action of alcohol. Then comes drowsiness, indifference, and later those brain functions that provide vital important processes in the body.

An alcoholic coma can occur if the blood alcohol content is 3%, which corresponds to severe alcohol poisoning. In some cases, even 300-500 ml drunk for alcohol can lead to an alcoholic coma. short span time. Alcohol is easily absorbed by the mucous membranes, a fifth of the dose drunk enters the blood from the stomach, the rest is gradually absorbed in the intestines.

The development of severe alcohol poisoning is facilitated by:

lack of food in the stomach (you can not drink alcoholic beverages on an empty stomach);
the amount of alcohol drunk (small doses of alcohol are excreted with sweat, urine, breathing, 90% of them decompose in the liver);
the strength of the alcoholic beverage (in strong drinks, the alcohol content is higher, but drinks with a strength of up to 30% are absorbed into the blood faster).

An alcoholic coma develops if the amount of alcohol in the blood is 0.3–0.7 ‰ (ppm), which is less than 0.5 liters of 96% alcohol drunk in a short period of time by a person of normal build. Death from alcohol occurs if the blood contains 5-8 g / l of ethanol.

Of course, the reaction to the reception alcoholic beverages everyone is different, and these are the most common indicators. There are people who go into an alcoholic coma even with smaller amounts of ethanol in their blood, while others need a higher dose. In addition, dense fatty food slows down absorption into the blood and alcohol is excreted before its concentration reaches a lethal one.

Stages of development of alcoholic coma

What is an alcoholic coma? How can you tell if a person is in a coma? An alcoholic coma is a condition when, against the background of taking alcoholic beverages, a person loses consciousness, he does not come to his senses even with a strong sound (scream), slaps, or the smell of ammonia.

With an alcoholic coma, the symptoms change as they deepen. There are 3 stages of coma.

If you find a person with signs of an alcoholic coma on the street, then you need to immediately call an ambulance! Signs of an alcoholic coma: lack of consciousness, no reaction to sound, slaps, constricted pupils and the smell of alcohol from the mouth.

The first symptoms of the onset of an alcoholic coma

When an alcoholic coma develops before your eyes, you can notice that after taking a certain dose of alcohol, a person begins to feel dizzy, he is disoriented, does not always understand where he is, confuses the location of rooms in a familiar place, cannot find necessary items. Pale face, weakness, constricted pupils, muscle twitching or convulsions - these are the first signs of the onset of an alcoholic coma.

If at this time to help him empty his stomach, causing vomiting, give 5-6 tablets activated carbon and lay it on its side, then there may not be a coma. The person will sleep. In the morning, of course, will suffer greatly from a hangover. He will have a headache, diarrhea and other dyspeptic symptoms (vomiting, nausea, heartburn) may occur. If there are no respiratory and cardiac disorders, then this condition can be treated at home. It is necessary to provide the patient with peace, as strong sounds, light can cause irritation and headache. Need to fix drinking regimen- drink plenty of water, juices, mineral water to quickly remove alcohol metabolic products from the body. You can drink pain medication.

First aid

When the patient has lost consciousness and does not respond to others, then urgently call an ambulance! Of course, initial stage alcohol coma often goes away on its own, but it's not worth the risk. How long does an alcoholic coma last if there are no heart and respiratory disorders? - it is not difficult to answer - no more than 6 hours. If during this time the patient's reaction to the environment has not changed, then the coma has already passed into the second stage, and it is required intensive therapy. it dangerous state, so you should not wait for a spontaneous exit from a coma, you need to call an ambulance at the first sign.

What should you do before the ambulance arrives? The main danger in the development of an alcoholic coma is respiratory failure due to aspiration (getting into Airways mucus, or vomit) or due to the retraction of the tongue, which blocks the entrance to the larynx and prevents the flow of air into the lungs. Therefore, if there are signs of an alcoholic coma, urgent first aid includes the following steps.

lay the patient on the left side

It is necessary to lay the patient on the left side. In order for its position to be stable, it is necessary to stretch left hand forward and bend his leg at the knee.
Clear mouth from vomit. It can be done index finger, wrapped with a piece of cloth, if there is no clip and gauze swabs at hand.
Excess mucus or vomit in the nasal passages is removed by emergency doctors with suction, but at home an ordinary douche will help.
In order not to sink the tongue, you can tilt your head back and push the lower jaw forward. To do this, press thumbs hands on corners mandible, and with the index they press on the chin, slightly opening the mouth. Emergency doctors can use a tongue holder or special air ducts for this.
When the patient has convulsions, you need to hold him so that he does not hit on nearby pieces of furniture.

First aid for alcoholic coma helps to avoid complications such as aspiration pneumonia. This is a dangerous condition caused by the ingestion of the contents of the stomach during vomiting into the lungs.

There is also another complication - laryngospasm, when, against the background of irritation with vomiting, vocal cords sharply compressed, and the patient can not inhale. In such a situation, urgent tracheal intubation may be necessary - a tracheotomy (a skin incision is made, subcutaneous tissue and trachea to form a hole with the external environment through which air will flow). Only a specialist can do this.

Principles of treatment

Alcoholic coma has an ICD 10 code - T51, which means that it is considered separate disease on international classification diseases.

In order to bring a person out of an alcoholic coma, the following therapeutic measures are necessary.

Consequences of an alcoholic coma

With timely adequate treatment, the patient comes out of an alcoholic coma within 2-4 hours. But even when favorable course alcoholic coma causes consequences in the form of bruises and injuries when falling, headache, memory impairment. Some of the consequences of an alcoholic coma can lead to deterioration of the patient's condition and death.

Alcoholic coma is a dangerous condition that can lead to death. At the first sign of a coma, call an ambulance, only timely medical care can save a person's life.

Everyone knows that alcohol causes great harm to human health. To drink or not to drink is everyone's business. Everyone chooses his own path in life. Therefore, do not try to convince a loved one, relative or acquaintance that you are right about alcohol. Alcohol is a catalyst for many diseases, it is well known, but not everyone knows that after alcohol poisoning, an alcoholic coma occurs.

What are the risks of ethyl coma?

There are three main risks associated with ethyl coma: hypothermia, muscle damage, and muscle damage. Hypothermia is a rapid drop in body temperature, which can lead to death if the victim is not treated in time while in a cool place.

Muscle damage is due to the relaxation of the body, which overwhelms the muscles when the person who is suffering from ethyl coma remains in the same position. Finally, choking is the most important risk of coma: weakening of the muscles causes weakening of the tongue, which can block breathing. Similarly, a victim of an alcoholic coma will not be able to evacuate his vomit if he is on his back. Both of these phenomena can lead to death when a person is not helped in time.

An alcohol coma can occur if the blood alcohol content is 3%, which corresponds to "severe alcohol poisoning". Alcohol is easily absorbed by the mucous membranes, one-fifth of the drunken dose enters the bloodstream from the stomach, and the rest is gradually absorbed into the intestines.

Lack of food in the stomach; the amount of alcohol consumed. . Of course, the reaction to alcohol is different for all people, and this is the most common indicator. There are people who get into an alcoholic coma with little ethanol in their blood, while others should have more. In addition, dense and fatty foods slow down absorption in the blood, and alcohol is excreted before the concentration reaches the mortal.

When diagnosing the symptoms of an alcoholic coma, it is worth knowing that it is sometimes combined with other types of coma.

Help

In the absence of pathologies and diseases, the patient comes out of the alcoholic coma on his own as the dose of ethyl alcohol in the blood decreases. On average, this happens in for three- five hours.

How can a person develop into a coma? An alcoholic coma is a condition when a person has lost consciousness on the background of drinking alcohol, does not come close to his feelings even with a strong sound, slaps, smells of ammonia. With an alcoholic coma, the symptoms change as they deepen.

If you find a person with signs of an alcoholic coma on the street, then you should immediately call an ambulance! Signs of an alcoholic coma: lack of conscience, lack of response to sound, slaps, student loans, and the smell of alcohol from the mouth. When an alcoholic coma develops in front of your eyes, you may notice that after taking a certain amount of alcohol, a person begins to feel dizzy, disorientated, does not always understand where he is, mixes up the placement of rooms in a family place, cannot find the right items.

The algorithm of actions to provide assistance is as follows:

Ensure normal breathing. Fix the tongue, put the victim on his side. If there was vomiting, clean the oral cavity from the remnants of vomit. This procedure will help ensure normal breathing.

The next step is gastric lavage. This is done with laxatives or a tube is used. Flushing with a probe in the hospital will not harm the victim. But when washing with other means, it must be brought to life, since washing the stomach in an unconscious state is fraught with a fatal outcome.

A pale face, weakness, lice, muscles or cramps are the first signs of an alcohol coma. If at this time to help him empty his stomach, induce vomiting, give 5-6 active charcoals and lie on one side, then there may not be a coma. In the morning, of course, he will suffer greatly from a hangover. It will have headache, diarrhea and other dyspepsia. If there is no respiratory and cardiac disorder, then this condition can be treated at home. You need to give the patient peace of mind, as strong sounds, lights can cause irritation and headaches.

It is also necessary to support the work of the heart, for this they use caffeine. With reduced

pressure, drugs that increase it are prescribed. After all, a dropper with vitamins, glucose and insulin is placed. With a prolonged alcoholic coma that lasts more than a day, the chances of positive outcome minimal. But if right help rendered in as soon as possible, that is, the ability to bring a person out of even the most severe coma.

It is necessary to create a drinking system a large number water, juices and minerals for quick removal metabolic products of alcohol from the body. When the patient has lost consciousness and does not respond to others, urgently ask for an ambulance! Of course, initial phase alcohol coma often goes away on its own, but it's not worth the risk. How long an alcoholic coma, if not, heart failure and breathing - it is not difficult to answer - no more than 6 hours. If the patient's response to environment has not changed during this time, then the coma has already passed to the second stage, and intensive therapy is needed.

It is vital to provide first aid as soon as possible. After all, as already mentioned, a coma sometimes leads to death.

If assistance was not provided on time, the causes of death may be the following:

Vomit. If a person lies on his back, he can choke on vomit.
Dehydration. When dehydrated, the human brain is damaged, which is the cause of death. Dehydration initiates seizures, which are sometimes incompatible with life.
Heart. It does not work in its usual mode. The heart beats irregularly and at one moment can stop.
Temperature. At a low body temperature, the heart stops and death occurs.

Alcoholic coma is preceded by intoxication with alcoholic substances.

This is a dangerous condition, so you should not expect a spontaneous regression from the coma, you should call an ambulance at the first sign. Main danger development of alcoholic coma - respiratory failure due to suction or sliding of the tongue, blocking the penetration of the larynx and preventing air from being taken into the lungs, therefore, if there are signs of an alcoholic coma, first aid in emergency includes the following steps. Throw the patient on the left side.

To keep your position stable, you need to stretch your left arm forward and bend your knee. This can be done with the index finger wrapped in a piece of cloth if there are no clamps or gauze pads. Excess mucus or vomit in the nasal passages, doctors remove first aid with aspiration, but at home it will help ordinary syringes. In order not to sink your tongue, you can tilt your head back and push your lower jaw forward. To do this, press your thumbs on bottom corners and press your chin against your chin, slightly opening your mouth. Doctors may use it for this tongue or special air passages. When a patient has convulsions, you must hold him so that he does not hit the surrounding environment.

You need to treat the patient on the left side.
Close mouth of vomit.

First aid for alcohol coma helps avoid complications such as aspiration pneumonia.

What not to do with alcohol intoxication:

Drink alcohol again.
Fulfill physical exercise, it is undesirable even to walk.
Leave the victim unattended.
Accept cold shower or in the bath.

Depending on the state of the person, conditionally, they divide the alcoholic coma into stages.

Stage 1

This is a dangerous condition caused by swallowing the contents of the stomach during vomiting in the lungs. In this situation, "urgent tracheal intubation - tracheotomy". In order to bring a person out of an alcoholic coma, it is necessary the following measures treatment.

With proper proper treatment, the patient leaves the coma within 2-4 hours. But even with the present advantage, alcohol coma causes bruising and falls in autumn, headache, memory alteration. Some of the dermal effects of alcohol can lead to deterioration of the patient's condition and death.

The first initial stage of an alcoholic coma is characterized by a violation of the brain. The person does not feel pain, is unconscious, unable to move, but the defense reflexes work. If you bring a cotton swab that has been soaked in ammonia to your nose, you will notice a not very pronounced facial expression, and protective movements will not be expressed. Other signs include vomiting, salivation, and uncontrolled urination. The content of alcohol substances in the blood is 4 ppm.

AT early signs coma, calling an ambulance, just "timely medical assistance", can save a person's life. Alcoholics die of diseases that this addiction or accidents cause, inattentively. One of the complications causing alcohol, is an alcoholic coma. Worst of all, an alcoholic coma can occur not only against alcoholism, because the toxic effect of alcohol can cause the development of a light drinking coma or a person who drinks only on holidays.

Stage 2

Salivation and urination may continue. The muscles are completely relaxed. Breathing is weak. During the gastric lavage procedure, muscle movements are either weak or completely absent. The pressure rises and the heartbeat. on the contrary, it decreases. The person completely loses consciousness and does not react to stimuli in any way. The content of alcohol in the blood is from 2 to 7 ppm.

Let's see why there is an alcoholic coma, what is it? Ethanol or alcohol that affects the human body causes alcohol poisoning. Even though many believe that alcohol can improve mood, it is relaxed - this is only the first phase of alcohol.

Alcohol is easily absorbed by the mucous membranes, one-fifth of the drunken dose enters the bloodstream of the stomach, and the rest is gradually absorbed into the intestines. In addition, dense, oily foods slow blood absorption, and alcohol is eliminated before the concentration reaches a lethal concentration. What is an alcoholic coma? How do we know what a person develops to whom? An alcoholic coma is a condition when a person has lost consciousness due to the use of alcoholic beverages, he does not even feel loud sound, blows, the smell of ammonia.

Stage 3

Respiration and pulse are weak. The pressure and body temperature are low. Also, the symptoms of the third stage are the lack of facial expressions, the pupils react poorly to light. Muscles are relaxed, there is no reaction to pain. There is also no reaction to ammonia. Skin covering pale, when touched there is a feeling of stickiness and moisture. The dose of alcohol in the blood is on average 5 ppm.

Signs and causes of coma

In an alcoholic coma, the symptoms change as you get deeper. If you find someone with signs of an alcoholic coma on the street, then you should immediately call an ambulance! Symbols of an alcoholic coma: lack of consciousness, lack of reaction to sound, blows, students are fed and the smell of alcohol from the mouth.

When an alcoholic coma develops in front of your eyes, you may notice that after you have taken a certain dose of alcohol, you begin to feel dizzy, he is disoriented, does not always know where he is, confuses the location of rooms in a familiar place, cannot find necessary elements. A pale face, weakness, busy students, muscle twitching or convulsions are the first signs of an alcoholic coma.

Effects

The use of small doses of alcohol does not go unnoticed by the body, let alone intoxication.

After the victim comes to his senses, he feels muscle weakness. Since he was immobilized all this time, some parts of the body were accordingly lying down. Now they hurt. Pain can also come from bruised areas. Before losing consciousness, a person could fall or hit against surrounding objects. Some Limbs are poorly controlled. The patient is dizzy and nauseous.

If at this moment you help him empty his stomach, induce vomiting, give 5-6 tablets of activated charcoal and lie down on one side, then there may not be a coma. In the morning, of course, they will suffer a lot of hangovers. There will be headaches, diarrhea and other dyspeptic phenomena. If there are no respiratory and cardiac disorders, this condition can be treated at home. It is necessary to ensure the calmness of the patient, as strong sounds, light can cause irritation and headaches. It is necessary to create a mode of drinking alcohol - drink plenty of water, juices, minerals in order to quickly remove alcohol from the body.

During a coma, alcohol causes irreparable harm nervous system and the brain. Liver cells die. Renal failure develops.

To come in normal condition will not succeed immediately. Sometimes it takes several days. During which the poisoned person will have urine dark color sometimes even with blood. How to avoid alcohol coma?

Rules for avoiding alcohol intoxication

Do not drink alcoholic beverages at a fast pace. It is better to diversify the pastime by talking, dancing, eating. So, alcoholic substances enter your body in small quantities gradually and it is easier to deal with them.

Avoid drinking carbonated alcoholic beverages. Because due to the gas bubbles, alcohol is more likely to be absorbed into the blood. Both intoxication and intoxication occur faster. Don't drink when hungry. An empty intestine, like carbonated drinks, contributes to the rapid entry of ethyl alcohol into the blood.

Alcoholic coma is a catastrophically dangerous and undesirable state of the body. It always leads to significant loss of health. The saddest consequence is death. Adolescents and the elderly are most susceptible to it, as in both of them the body is not able to cope with large doses alcohol.

It should be noted that not only alcohol itself is harmful to a person, but also harmful substances that enter the body together with it. There can be only one advice here - drink wisely or refuse this addiction. After all, there are so many ways to cheer yourself up and in addition to drinking alcohol. In any case, it's up to you.

Everyone knows that excessive consumption of alcoholic beverages can cause such a serious condition as acute, but few people know about the existence of a condition called alcoholic coma. The danger of this condition lies in the fact that such severe alcohol intoxication leads to death most often compared to other types of poisoning.

After drinking alcohol, 2 phases of its content in the blood are distinguished. In phase 1, which is known in medicine as resorption, alcohol with its toxic substances spreads through the body through the blood, penetrates into tissues, cells and organs. The time for which alcohol is completely distributed throughout your body depends on the individual characteristics of the nervous system, gastrointestinal tract, how accustomed you are to drinking alcohol, your temperature, etc. Also, if you drink alcohol in a full state, its absorption is almost two times slower than if you take it on an empty stomach. At next appointment the duration of its absorption is counted from the last intake of alcohol.

The process of spreading alcohol throughout the body can be slowed down due to paralysis gastric peristalsis, this happens due to the fact that alcohol is taken by a person who is not accustomed to its frequent use.

It is clear that the more alcohol is drunk, the greater its content in the blood. Exactly the same dependence in relation to the frequency of drinking and its volume.

In the urine, alcohol is determined already 10 minutes after reaching the maximum of its blood content.

At the end of phase 1, alcohol has already been introduced into the blood almost completely, and the next, second phase lasts for 5-12 hours. At this time, the amount of alcohol may begin to decrease, or remain in the same amount. Gradually, its amount becomes equal to the normal, acceptable for the body. Ethyl alcohol is oxidized in the liver at a rate of 6-7 g / h, of which only 10% is excreted with sweat, urine or exhaled air.

With the use of alcohol, especially with its excessive use, there is pernicious influence on the central nervous system: the reaction is inhibited, the work of receptors is disrupted.

When it enters the body a small amount of alcohols, then there is an acceleration of heart contractions, blood pressure rises, blood vessels dilate, breathing quickens.

With such symptoms, it is clear that alcohol affects not only the liver, but, to the same extent, the brain.

Clinic

Severe alcohol intoxication gets too much ethyl alcohol into the body and the central nervous system gets a huge blow, causing coma, disruption of the respiratory center, asphyxia and lowering blood pressure. A person falls into a state called an alcoholic coma, the consequences of an alcoholic coma can be irreversible.
Who is divided into 3 stages, each of which has several degrees.
First stage.
This is the initial stage of coma, in which the main signs are violations of the functions of the brain, its cortical-subcortical zones. The person is unconscious, does not feel pain, cannot move, protective reflexes do not work. But nevertheless, in this state, temporary disinhibition of reflexes and hypertonicity are noted, as a result of which the muscles of the chest twitch. The body temperature does not rise, the pupils are constricted, and with pressure on the trigeminal nerve, they expand, reacting to pain, facial expressions are not obvious, but still pronounced.

Help with an alcoholic coma in the form of bringing a cotton swab moistened with ammonia to the nose causes weak facial movements, protective movements are absent or weakly expressed. The victim has a slight bronchorrhea, wheezing is heard in the bronchi against the background of shortness of breath, tachycardia, but blood pressure is either normal or slightly elevated. There is slight salivation, vomiting, spontaneous urination(because bladder usually crowded). At this stage, the amount of alcohol in the blood reaches an average of 4 ppm, and in the urine - 6 ppm.

The second degree is characterized by a complete loss of consciousness and the absence of any reflexes. The pupils react poorly to light, the victims do not feel pain, but when you press on certain areas of the trigeminal nerve, a weak reaction of the limbs and facial expressions is still noted. Muscles are not in good shape. Such acute alcohol intoxication is characterized by weak breathing, wheezing in the chest, weak muscle movement even during gastric lavage and other medical measures. Arterial pressure is increased, heart rate does not exceed 80-100 beats per minute. Involuntary urine and salivation continues. The amount of alcohol in the blood at the second stage is 2.5-6.5 ppm, and in the urine about 2.5-8.0 ppm.

The third stage is known as deep alcoholic coma. Signs of this stage are related to neurology. A coma is accompanied by constricted pupils, slightly expanding when breathing is disturbed. The pupils do not react to light at all, or react weakly. Muscles are weakened, reflexes are not observed even for pain. When bringing a cotton wool moistened with ammonia, there is no reaction.
To these signs are added manifestations of acrocyanosis - pallor of the skin, its stickiness, humidity and a decrease in temperature to 35 degrees. Respiration is significantly slowed down, the pulse is weak, blood pressure is lowered to 100/60 mm. rt. Art.
This is called exotoxic shock. The amount of alcohol in the blood is about 5 ppm, in the urine - about 6.

It is also characterized by salivation and involuntary urination, the tongue is prone to sinking, vomit can enter the respiratory tract. Breathing is slowed down, up to its complete stop.

Due to the long non-replaceable position of the patient, a crash syndrome often occurs: a syndrome of prolonged muscle compression, when, under the weight of the patient’s own body, the patient’s muscles are flattened and myoglobin from them enters the bloodstream, to some extent excreted by the kidneys. It is fraught with serious complications, such as kidney failure. In extremely severe cases disease leads to death.

With a decrease in the amount of alcohol in the body, the patient's condition becomes much better. However, not only this is an indicator of how severe the consequences for his body are. Both the symptoms of an alcoholic coma are important here, and additional examination the victim.

First aid and treatment

It is very important that first aid for an alcoholic coma be done as soon as possible. First of all, it is necessary to free the oral cavity from vomit in order to prevent their entry into the respiratory tract. For the same reason, a person should be laid on his side. There is also a danger of the tongue falling, so it is recommended to use a tongue holder to secure it. The rescue team should soon remove the mucus from the nasopharynx.

The second step is to rapid elimination alcohol from the body. Usually in such cases, the stomach is washed using a probe, laxatives are used. Often for victims who are in a coma, atropine is administered. To support the work of the heart, caffeine and cordiamine are used. With first aid to help the heart, you can do the following: for half a minute, press hard with your fingernail on the tip of the nose, on the point between lower lip and the chin (at the center of the furrow) and at a point approximately 1/3 between the tip of the nose and the upper lip.

By and large, all symptoms are removed. If you provide assistance quickly and correctly (both first and professional medical), then even from the most difficult state of an alcoholic coma, a person can be taken out. If the coma lasts more than 24 hours, then the chances of a successful outcome rarely decrease.

Attention! In no case should you wash the stomach during first aid to an unconscious victim. Probe rinsing only medical institution may not do any harm.

Causes of an alcoholic coma

An alcoholic coma can occur if the blood alcohol content is 3%, which corresponds to severe alcohol poisoning. In some cases, even 300-500 ml drunk in a short period of time can lead to an alcoholic coma. Alcohol is easily absorbed by the mucous membranes, a fifth of the dose drunk enters the blood from the stomach, the rest is gradually absorbed in the intestines.

The development of severe alcohol poisoning is facilitated by:

lack of food in the stomach (you can not drink alcoholic beverages on an empty stomach);
the amount of alcohol drunk (small doses of alcohol are excreted with sweat, urine, breathing, 90% of them decompose in the liver);
the strength of the alcoholic beverage (in strong drinks, the alcohol content is higher, but drinks with a strength of up to 30% are absorbed into the blood faster).

Of course, the reaction to the intake of alcoholic beverages is different for all people, and these are the most common indicators. There are people who go into an alcoholic coma even with smaller amounts of ethanol in their blood, while others need a higher dose. In addition, dense, fatty foods slow down absorption into the bloodstream and alcohol is excreted before its concentration reaches a lethal one.

Stages of development of alcoholic coma

With an alcoholic coma, the symptoms change as they deepen. There are 3 stages of coma.

If you find a person with signs of an alcoholic coma on the street, then you need to immediately call an ambulance! Signs of an alcoholic coma: lack of consciousness, no reaction to sound, slaps, constricted pupils and the smell of alcohol from the mouth.

The first symptoms of the onset of an alcoholic coma

When an alcoholic coma develops before your eyes, you can notice that after taking a certain dose of alcohol, a person begins to feel dizzy, he is disoriented, does not always understand where he is, confuses the location of rooms in a familiar place, cannot find the necessary items. A pale face, weakness, constricted pupils, muscle twitching or convulsions are the first signs of an alcohol coma.

If at this time you help him empty his stomach, causing vomiting, give 5-6 tablets of activated charcoal and lay him on his side, then there may not be a coma. The person will sleep. In the morning, of course, will suffer greatly from a hangover. He will have a headache, diarrhea and other dyspeptic symptoms (vomiting, nausea, heartburn) may occur. If there are no respiratory and cardiac disorders, then this condition can be treated at home. It is necessary to provide the patient with peace, as strong sounds, light can cause irritation and headache. It is necessary to establish a drinking regimen - drink plenty of water, juices, mineral water, in order to quickly remove alcohol metabolic products from the body. You can drink pain medication.

First aid

When the patient has lost consciousness and does not respond to others, then urgently call an ambulance! Of course, the initial stage of an alcoholic coma often goes away on its own, but it's not worth the risk. How long does an alcoholic coma last if there are no heart and respiratory disorders? - it is not difficult to answer - no more than 6 hours. If during this time the patient's reaction to the environment has not changed, then the coma has already passed into the second stage, and intensive therapy is required. This is a dangerous condition, so you should not wait for a spontaneous exit from a coma, you need to call an ambulance at the first sign.

What should you do before the ambulance arrives? The main danger in the development of an alcoholic coma is a violation of breathing due to aspiration (the entry of mucus or vomit into the respiratory tract) or due to the retraction of the tongue, which blocks the entrance to the larynx and interferes with the flow of air into the lungs. Therefore, if there are signs of an alcoholic coma, emergency first aid includes the following actions.

lay the patient on the left side

It is necessary to lay the patient on the left side. In order for his position to be stable, it is necessary to stretch his left arm forward and bend his leg at the knee.
Clear mouth from vomit. This can be done with the index finger wrapped in a piece of cloth if there is no clamp and gauze swabs at hand.
Excess mucus or vomit in the nasal passages is removed by emergency doctors with suction, but at home an ordinary douche will help.
In order not to sink the tongue, you can tilt your head back and push the lower jaw forward. To do this, they press with their thumbs on the corners of the lower jaw, and with their index fingers they press on the chin, slightly opening the mouth. Emergency doctors can use a tongue holder or special air ducts for this.
When the patient has convulsions, you need to hold him so that he does not hit on nearby pieces of furniture.

First aid for alcoholic coma helps to avoid complications such as aspiration pneumonia. This is a dangerous condition caused by the ingestion of the contents of the stomach during vomiting into the lungs.

There is also another complication - laryngospasm, when, against the background of irritation with vomiting, the vocal cords are sharply compressed, and the patient cannot breathe. In such a situation, urgent tracheal intubation may be necessary - a tracheotomy (an incision is made in the skin, subcutaneous tissue and trachea to form a hole with the external environment through which air will flow). Only a specialist can do this.

Principles of treatment

Alcoholic coma has an ICD 10 code - T51, which means that it is considered a separate disease according to the international classification of diseases.

In order to bring a person out of an alcoholic coma, the following therapeutic measures are necessary.

Consequences of an alcoholic coma

With timely adequate treatment, the patient comes out of an alcoholic coma within 2-4 hours. But even with a favorable course, an alcoholic coma causes consequences in the form of bruises and injuries when falling, headaches, and memory impairment. Some of the consequences of an alcoholic coma can lead to deterioration of the patient's condition and death.

Alcoholic coma is a dangerous condition that can lead to death. At the first sign of a coma, call an ambulance, only timely medical care can save a person's life.

Excessive intake of alcoholic beverages often leads to a serious condition, like acute alcohol intoxication, which is known to many. There are cases when, under the influence of alcohol on the body, serious condition like an alcoholic coma. It is dangerous because, unlike simple alcohol poisoning, this condition is fatal. According to today, along with other poisonings, it is the most insidious.

Alcoholic coma is a severe poisoning with ethyl alcohol, as a result of this exposure, the reaction to external stimuli is lost, the nerve centers and breathing, as well as disturbed thermoregulation of the human body. The word "coma" means sleep. But in modern medicine this term under the influence of alcohol poisoning is not at all similar to normal sleep . In this condition, the swallowing and cough reflex are disturbed, there is a weakening of the muscles that control the movement of the tongue. Due to this failure, vomit can enter the body through the trachea.

Alcoholic coma affects the body in such a way that most often ventilation of the lungs is reduced, and breathing is depressed. Alcoholics and first-time drinkers can trigger this life-threatening condition. The cause of this condition is the neurotoxic effect of ethanol on the brain, which is first characterized by excitation, then is replaced by a slowdown in the entire activity of the respiratory center.

Ethanol provokes swelling of tissues, while reducing fluid in the body, and the total volume of blood. This process is called hypovolemia, it contributes to the occurrence of muscle cramps, lowering the temperature and general weakness. All these disorders lead to a decrease in blood pressure, which increases blood viscosity. The blood concentration of 3 g / l can provoke a coma, the concentration of up to 5 g / l is close to the probability of death.

State Clinic

The conditions caused by coma are accompanied by a whole list, some of them develop as serious illnesses organism, while others are characterized by dysfunction of organs. With intoxication, swelling occurs, limbs weaken, coordination of movements is disturbed, sensitivity is impaired, protein and toxins accumulate in the urine. There is a renal, and acute insufficiency, in which the functions of the kidneys are impaired, their filtration decreases. Water, nitrogen and electrolyte metabolism develop symptoms such as:

muscle atrophy;
trophic changes in the body;
hyperkalemia;
hemorrhagic syndrome;
symptoms of uremia.

Drinking too much alcohol leads to a coma. Affects the strength of the alcoholic beverage, naturally with a strength of more than 12 percent more likely body poisoning. It also depends on the human body and the reaction, for each it can occur individually. The amount of food eaten also affects alcohol poisoning. The consequences of a coma are usually a catastrophic diagnosis, especially for the brain. As a result of this state, a complete degradation of the personality occurs.

Alcoholic coma causes the process of myoglobinuria, in which the striated muscles are affected. They are amazed when, under the weight of the patient, they prolonged squeezing. Due to this, muscle fibers are destroyed and development takes place. kidney failure which is manifested by anemia. If this process is started, then it can develop rapidly, in which case the probability of death is very high. Victims after their recovery from a coma suffer severe muscle pain. The tissues that surround the muscles become denser with a large edema.

Stage characteristics

Alcoholic coma is one of the conditions that occurs against the background of alcohol abuse and destroys the human body. First of all, you need to take care of your health and think about the inevitable consequences that may occur as a result of a coma. The state of coma is a difficult process, it has three stages. At the first stage, which is initial and superficial, all cortical and subcortical functions are disrupted, due to a malfunction in the work of all brain functions.

The patient loses consciousness. He is unable to feel pain, work protective reflexes is absent, but despite this, a temporary revival of reflexes that slow down the muscles is fixed chest. On the this stage body temperature is not elevated, the pupils are slightly constricted, facial expressions are weakly expressed. Shortness of breath, tachycardia is also formed, there is hoarse breathing, vomiting and involuntary urination are often present. The impact on the patient with the help of an ammonia solution in the form of inhalation gives a mimic reaction and weak protective movements are noticed.

The second stage is characterized by a deterioration in the patient's condition, a sharp suppression of all brain functions. Complete oppression of all tendon centers, a sharp decline pupillary, pharyngeal and cough reflex accompanied by a decrease in muscle tone. At strong pressure on the pain points there may be a slight sensitivity of the upper and lower extremities, which goes away very quickly. At therapeutic measures, and in response to painful stimuli, muscle twitching occurs, which immediately disappear at rest.

Of all the stages of coma, the most dangerous is the third. Symptoms of neurological etiology predominate, the stage is deeper than the first and second. Its manifestation is usually in the most severe poisoning. The patient is in a deep coma complete absence fundamental, pharyngeal and tendon reflexes, the pupils do not respond to their action from the outside. At the same time, the skin is pale, cold, moist, at low body temperature. There is a rare respiratory rate with interruptions, heart rate with a very low frequency. medical expertise provided data according to which among all poisonings, alcohol leads in terms of mortality.

Help with coma

If symptoms of a coma appear in a patient, it is required to immediately call an ambulance, while specialists have not yet arrived, the victim must be independently assisted. Health care in severe coma, it turns out to be the removal of alcohol from the body. Doctors stop the absorption of alcohol from the digestive system into the bloodstream by gastric lavage using a probe. At the same time intravenously injected hypertonic solution glucose with insulin.

Then a saline solution is injected into the vein, which contains glucose, insulin, soda, as well as vitamins B1, B6, and ascorbic acid. Vitamin C helps to prevent the entry of alcohol into the body. This composition of drugs helps the body fight the consequences that the coma caused. The introduction of caffeine to the patient serves to support the work of the heart, and the injection of atropine serves to reduce salivation and helps to avoid the flow of saliva into the trachea. Against the background of these complications, a disease such as aspiration pneumonia may occur.

Doctors usually prescribe antibiotic therapy to prevent the diagnosis of pneumonia as dysfunction occurs. respiratory organs and urgent artificial ventilation lungs.

Physicians prescribe a number of procedures that are carried out with the help of medicines prevent these comatose states. It is not known how long alcohol intoxication can last, depending on the age of the person, his gender, the amount of alcohol taken in the body.

Manifestation of a strong alcohol intoxication usually occurs when hit huge amount alcohol into the human body, resulting in coma, since a big blow is applied to the nervous system, a decrease in blood pressure, asphyxia can be transformed. You can never guess what consequences a coma will entail, very often irreversible. If the patient is not given prompt and complex treatment, then one of the consequences will be inevitable death.

The consequences of an alcoholic coma occur when alcohol is abused, which often leads to an alcoholic coma. With cravings for alcohol, which affects the organs human body, and is accompanied by the systematic use of alcohol, and also forms a pathological attraction to them, physical and mental dependence may occur in a coma. Which harms the body and many diseases. Most often, patients die from diseases that this addiction leads to.