Alcoholic coma and other ending options. Causes and consequences of alcoholic coma

Everyone knows what alcohol does great harm human health. To drink or not to drink is everyone's business. Everyone chooses their 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, this is well known, but not everyone knows that after alcohol poisoning, an alcoholic coma occurs.

What are the risks of an 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 that can lead to death if the victim is not kept in a cool place in time.

The muscle damage is due to the relaxation of the body that crushes the muscles when a person who is suffering from an ethyl coma remains in the same position. Finally, suffocation is the most important risk coma: weakening of the muscles causes a weakening of the tongue, which can block breathing. Likewise, 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.

Alcohol coma can occur if the blood alcohol level is 3%, which corresponds to “severe alcohol poisoning.” Alcohol is easily absorbed by the mucous membranes, one fifth of the drunk dose enters the blood from the stomach, and the rest is gradually absorbed into the intestines.

Lack of food in the stomach; amount of alcohol consumed. . Of course, the reaction to alcohol is different for all people, and this is the most general indicator. There are people who acquire alcoholic coma and not big amount ethanol in the blood, while others should have more. In addition, dense and fatty foods slow absorption into the blood, and alcohol is eliminated before the concentration reaches mortals.

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

Help

In the absence of pathologies and diseases, the patient comes out of an alcoholic coma on his own as the dose is reduced ethyl alcohol in blood. On average, this happens within three to five hours.

How can a person develop into a coma? Alcoholic coma is a state when a person has lost consciousness due to alcohol consumption and does not approach his feelings even with a strong sound, slaps, or ammonia smells. With an alcoholic coma, the symptoms change as the coma gets deeper.

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

The algorithm for providing assistance is as follows:

Provide normal breathing. Fix the tongue and place the victim on his side. If there was vomiting, clear the oral cavity of any remaining vomit. This procedure will help ensure normal breathing.

The next step is gastric lavage. This is done using laxatives or using a probe. Flushing with a probe in the hospital will not harm the victim. But when lavaging with other means, he must be brought to his senses, since gastric lavage in an unconscious state is fraught with fatal consequences.

A pale face, weakness, lice, muscles or cramps are the first signs of an alcoholic 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 be no coma. In the morning, of course, he will suffer greatly from a hangover. This will have headache, diarrhea and other dyspeptic symptoms. If there is no breathing or heart problem, then this condition can be treated at home. You need to provide the patient with peace of mind, as strong sounds and light can cause irritation and headaches.

It is also necessary to support the functioning of the heart; caffeine is used for this. At reduced

pressure, drugs to increase it are prescribed. After everything, a drip with vitamins, glucose and insulin is placed. For prolonged periods alcoholic coma, which lasts more than a day, the chances of a positive outcome are minimal. But if the right help provided 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 system of drinking plenty of water, juices and minerals for quick removal alcohol metabolism products from the body. When the patient is unconscious and unresponsive to others, ask an ambulance immediately! Of course, the initial phase of an alcoholic coma often goes away on its own, but it’s not worth the risk. How long is an alcoholic coma, if not, heart failure and breathing - it is not difficult to answer - no more than 6 hours. If the patient's reaction to environment has not changed during this time, then the coma has already entered the second stage, and it is necessary intensive therapy.

It is vitally important to provide first aid as quickly as possible. After all, as already mentioned, coma sometimes leads to death.

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

• Vomit. If a person lies on his back, he may choke on vomit.
• Dehydration. When dehydration occurs, a person's brain is damaged, which causes death. Dehydration initiates convulsions, which are sometimes incompatible with life.
• Heart. It does not work in its usual mode. The heart does not beat regularly and may stop at one moment.
• Temperature. When the body temperature is low, 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 recovery from the coma; you should call an ambulance at the first sign. Main danger development of alcoholic coma - breathing impairment due to suction or sliding of the tongue, blocking the penetration of the larynx and preventing the intake of air in the lungs, therefore, if there are signs of 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 left hand forward and bend your knee. This can be done using the index finger wrapped in a piece of cloth if clamps and gauze pads are not available. Excess mucus or vomit in the nasal passages, doctors quickly remove it using aspiration, but at home, regular syringes will help. To prevent your tongue from sinking, you can tilt your head back and push your lower jaw forward. To do this, press your thumbs on the bottom corners and press your chin against your chin, opening your mouth slightly. Doctors may use it for this tongue or special air passages. When the patient has a seizure, you must hold him to prevent him from hitting the surrounding environment.

• You need to treat the patient on the left side.
• Cover your vomiting mouth.

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

What not to do if you have alcohol intoxication:

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

Depending on the person’s condition, alcoholic coma is conventionally divided into stages.

Stage 1

This is a dangerous condition caused by swallowing stomach contents while vomiting into 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 current advantage, alcohol coma causes consequences in the form of bruises and falls in the fall, headache, memory changes. Some of the skin effects of alcohol can lead to deterioration of the patient's condition and death.

The first initial stage of alcoholic coma is characterized by disruption of brain function. The person does not feel pain, is unconscious, cannot move, but the defense reflexes are triggered. If you bring a cotton swab dipped in ammonia to your nose, you will notice not very pronounced facial expressions, and protective movements will not be expressed. Other signs include vomiting, salivation and uncontrolled urination. The content of alcohol in the blood is 4 ppm.

IN early signs coma, calling an ambulance, just “timely health care", can save a person's life. Alcoholics die from diseases to which this addiction or accidents cause, without attention. One of the complications caused by alcohol is alcoholic coma. The worst thing is that an alcoholic coma can occur not only against alcoholism, because the toxic effect of alcohol can cause the development of weak drinking coma or a person who only drinks 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. Blood pressure rises and heart rate increases. on the contrary, it decreases. The person completely loses consciousness and does not react to stimuli in any way. The blood alcohol content 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 people believe that alcohol can improve your mood, it is relaxed - this is only the first phase of alcohol.

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

Stage 3

Breathing and pulse are weak. Blood pressure and body temperature are low. Also, the symptoms of the third stage are the absence of facial expressions, the pupils react poorly to light. The muscles are relaxed, there is no reaction to pain. There is also a complete lack of reaction to ammonia. The skin is 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 alcohol 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, feeding students and the smell of alcohol from the mouth.

When an alcoholic coma develops before your eyes, you may notice that after you have taken a certain dose of alcohol, you begin to feel dizzy, disoriented, do not always know where you are, are confused by the layout of rooms in a familiar place, cannot find necessary elements. A pale face, weakness, busy students, muscle twitching or seizures are the first signs of an alcoholic coma.

Consequences

The consumption 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 his body lay down accordingly. Now they hurt. Pain can also come from bruised areas. Before losing consciousness, a person could fall or hit surrounding objects. Some Limbs are poorly controlled. The patient feels 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 be no coma. In the morning, of course, they will suffer a lot of hangover. There will be headaches, diarrhea and other dyspeptic symptoms. If there are no breathing or heart problems, this condition can be treated at home. It is necessary to ensure the patient's calm, as strong sounds and light can cause irritation and headaches. It is necessary to create a regime for drinking alcohol - drink a lot of water, juices, minerals in order to quickly remove alcohol products from the body.

During a coma, alcohol causes irreparable harm nervous system and brain. Liver cells die. Developing renal failure.

To come in normal condition It won't be possible right away. Sometimes it takes several days. During which time 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 your pastime by talking, dancing, and eating food. Thus, alcoholic substances enter your body gradually in small quantities and are easier to deal with.

Avoid drinking carbonated alcoholic drinks. Because due to gas bubbles, alcohol is more quickly absorbed into the blood. Both intoxication and intoxication occur faster. Don't drink when you're hungry. An empty intestine, like carbonated drinks, allows ethyl alcohol to quickly enter the bloodstream.

Alcoholic coma is a catastrophically dangerous and undesirable state of the body. It always leads to significant health losses. Its saddest consequence is death. Teenagers and older people are most susceptible to it, since in both cases the body is not able to cope with large doses alcohol.

It is worth noting that not only alcohol itself is harmful to humans, but also harmful substances, which enter the body together with it. There can only be one piece of advice here - drink wisely or give up this bad habit. After all, there are so many ways to cheer yourself up other than 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 is that such severe alcohol intoxication leads to death more often than other types of poisoning.

After drinking alcohol, there are 2 phases of its content in the blood. During phase 1, which is known in medicine as resorption, alcohol with its toxic substances is distributed by the blood throughout the body, penetrating into tissues, cells and organs. The time it takes for alcohol to be completely distributed throughout your body depends on your individual characteristics. nervous system, gastrointestinal tract, how habitual you are to drinking alcohol, your temperature, etc. Also, if you drink alcohol in a full state, its absorption occurs almost twice as slow as 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 distributing alcohol throughout the body can be slowed down due to paralysis of gastric peristalsis, this happens due to the fact that alcohol is taken by a person who is not accustomed to drinking it frequently.

It is clear that the more alcohol you drink, the higher its content in the blood. Exactly the same relationship applies to the frequency of drinking and its volume.

Alcohol is detected in urine within 10 minutes after the maximum blood content has been reached.

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

When drinking alcohol, especially when drinking it excessively, there is harmful influence on the central nervous system: the reaction is inhibited, the functioning of receptors is disrupted.

When a small amount of alcohol enters the body, heart rate accelerates, blood pressure rises, blood vessels dilate, and 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 causes too much ethyl alcohol to enter the body and the central nervous system receives a huge blow, causing coma, disruption of the respiratory center, asphyxia and decreased blood pressure. A person falls into a state called an alcoholic coma; the consequences of an alcoholic coma can be irreversible.
Coma is divided into 3 stages, each of which has several degrees.
First stage.
This is the initial stage of coma, in which the main symptoms are dysfunctions of the brain and its cortical-subcortical zones. The person is unconscious, does not feel pain, cannot move, and 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 increase, the pupils are constricted, and when pressure is applied to the trigeminal nerve, they expand, reacting to pain; facial expressions are not obvious, but still expressed.

Help for alcoholic coma in the form of holding a cotton swab soaked in ammonia to the nose causes weak facial movements, protective movements are absent or weakly expressed. The victim has slight bronchorrhea, wheezing is heard in the bronchi against the background of shortness of breath, tachycardia, but blood pressure is either normal or slightly increased. There is slight salivation, vomiting, and spontaneous urination (since 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 weakly to light, victims do not feel pain, but when certain areas of the trigeminal nerve are pressed, a weak reaction of the limbs and facial expressions is still observed. The 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 care measures. Blood 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. The signs of this stage relate to neurology. A comatose state is accompanied by constricted pupils, which dilate slightly when breathing is impaired. The pupils do not react to light at all, or react weakly. The muscles are weakened, there are no reflexes even to pain. When a cotton swab moistened with ammonia is presented, there is no reaction.
To these signs are added the manifestations of acrocyanosis - paleness of the skin, its stickiness, humidity and a decrease in temperature to 35 degrees. Breathing is significantly slower, pulse is weak, blood pressure is reduced to 100/60 mm. rt. Art.
A so-called exotoxic shock appears. The amount of alcohol in the blood is about 5 ppm, in the urine – about 6.

Salivation and involuntary urination are also characteristic, the tongue is prone to recess, vomit can enter the Airways. Breathing is slowed down, until it stops completely.

Due to the patient's long non-removable position, crash syndrome often occurs: syndrome prolonged compression muscles when under weight own body the patient’s muscles are flattened and myoglobin from them enters the blood, to some extent being excreted by the kidneys. This can lead to serious complications such as kidney failure. Extremely severe cases the disease leads to death.

When the amount of alcohol in the body decreases, the patient's condition becomes significantly better. However, this is not the only indicator of how severe the consequences are for his body. Both the symptoms of alcoholic coma and additional examination the victim.

First aid and treatment

It is very important that first aid for alcoholic coma is carried out as soon as possible. First of all, it is necessary to empty the oral cavity of vomit to prevent it from entering the respiratory tract. For the same reason, a person should be placed on his side. There is also a danger of the tongue sinking, so it is recommended to use a tongue holder to secure it. The emergency team should quickly clear the mucus from the nasopharynx.

The second step is to rapid elimination alcohol from the body. Usually in such cases the stomach is washed out using a tube and laxatives are used. Atropine is often administered to comatose victims. Caffeine and cordiamine are used to support heart function. In first aid to help the heart, you can do the following: for half a minute, press firmly with your nail on the tip of your nose, on the point between lower lip and chin (at the center of the groove) and to a point located approximately 1/3 between the tip of the nose and the upper lip. An IV with insulin and glucose is installed, B vitamins are administered. If blood pressure is low, medications are prescribed to raise it.

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

Attention! Under no circumstances should you rinse the stomach during first aid to an unconscious victim. Only rinsing with a probe in medical institution may not do any harm.

One of the most dangerous consequences For health, alcoholism is an alcoholic coma. Abuse of alcohol-containing drinks often leads to loss of concentration, difficulty breathing, sudden changes in temperature, and problems of the nervous system. This condition is dangerous, especially if you ignore the symptoms and do not seek the help of specialists. How to avoid the problem, and in as a last resort- get rid of her?

What is alcoholic coma

When drinking too much alcohol, a person can fall into a state called alcoholic coma. This is very dangerous to health and is often incompatible with life. Problems begin when the blood alcohol concentration is 300-500 ml. 1600 ml leads to severe toxic syndrome. Around 1800 - coma. Higher - lethal dose. Doctors call it strong alcohol intoxication. IN in rare cases even small dose alcohol, drunk in a short period of time, leads to a coma.

Stages

Coma due to acute alcohol poisoning has three stages:

1. Superficial coma or first stage. Loss of consciousness, gagging, excessive salivation, constriction of the pupils, change in skin tone to blue, muscle tissue in hypertonicity, thermoregulation failures.
2. Second stage. Low blood pressure, slow shallow breathing, rapid but weak pulse, absence of muscle and tendon reflexes, presence of a reaction when pressing on painful points. Involuntary urination, defecation, worsened reaction to external stimuli. Involuntary convulsions are observed.
3. Deep coma. The third stage is characterized by a weak pulse and breathing, accompanied by disturbances in cardiac and pulmonary rhythm, complete absence reflexes, expressive blue skin tone, dilated pupils. Elevated levels of ethanol in the blood can cause cardiac and/or respiratory failure. If emergency assistance is not provided, the patient may die due to a sunken tongue or triggered gag reflex.

Causes

Heavy drinkers will call the cause of the comatose state inexperience:

• drinking alcohol on an empty stomach;
• drinking a lot of alcohol a short time;
• varying alcohol strength.

However, both a beginner and an avid alcohol drinker can fall into a coma due to drinking. It is better to avoid alcohol-containing drinks, but if you want to drink, you must follow a number of rules: simple rules: do not drink on an empty stomach, do not lower the temperature and stop when alcohol does not cause euphoria, but lethargy, foggy thinking, problems with coordination.

Symptoms

Main characteristic features alcoholic coma: loss of consciousness, pale skin, low temperature. It is important to take the symptoms seriously, because if you simply put the patient to sleep, there is a risk of developing a coma. If there are 3 g of ethyl per liter of human blood, a comatose reaction begins. If the dose is 5 grams or more, there is a risk fatal outcome.

Diagnostics

Coma caused by excess alcohol is diagnosed in the presence of a comatose state, a characteristic odor on the exhale and the above symptoms. After providing emergency care, specialists consider the possibility of a combination of several types of coma. For example, a coma provoked by alcohol is often combined with neurological, somatic or toxic coma.

To diagnose several types of coma, medicine uses a number of tests, studies and radiation. In a standard situation, specialists determine the stage of coma using tests or tactile examinations. Echoencephaloscopy or lumbar puncture may also take part in the examination. Doctors often find that coma develops and causes kidney or liver problems, pancreatitis, or diabetic coma. All this is also caused severe poisoning ethyl alcohol.

First aid for alcoholic coma

The main danger is to suffocate or choke before the ambulance arrives due to copious discharge saliva and vomit. The patient's tongue may become stuck, preventing him from breathing. If you notice symptoms of a comatose state in a person, do the following:

1. Lay the person on their side. You need to extend your left arm and bend right leg at an angle of 90 degrees.
2. Oral cavity need to clean up vomit or excess saliva. To do this, you need to wrap your finger in a clean cloth or gauze and clear your mouth, which will reduce the strain on the respiratory tract.
3. Vomit or mucus may also be concentrated in the nose. You can get rid of it using a syringe.
4. You can prevent the tongue from sinking by tilting the patient's head back and pushing the lower jaw forward.
5. If a person begins to convulse, try to restrain him so that the patient does not get injured due to nearby pieces of furniture.

Treatment methods

To clear the stomach of excess alcohol that has not been absorbed into the blood, you should call vomiting reflex. The process must be controlled, otherwise the person may choke. Activated carbon powder combined with plenty of water will help cleanse your stomach. If you lose consciousness, cotton wool with ammonia will help. If a person does not regain consciousness for a long time, consult a doctor. At the hospital, the patient will have a gastric lavage, a drip, and a series of procedures. Once the patient regains consciousness, the doctor will prescribe medications and antibiotics.

Consequences of alcoholic coma

After recovering from a critical condition, the patient will experience swelling of the extremities, a change in the color of urine to brown, sometimes dark red. There is a risk of heart disease and pulmonary insufficiency, hyperkalemia (unacceptably high potassium content in the blood), trophic transformations (rejection of the skin, ulcers, inflammation), muscle atrophy (loss of muscle mass, imbalance of muscle tone), hemorrhagic syndrome (bleeding of mucous membranes). It's important not to resort traditional methods treatment, but contact specialists so as not to worsen the consequences.

Video

No one doubts that alcoholism is a disease. Treatment for alcoholism is long and complex. Alcoholics die from diseases that this addiction leads to or from accidents due to negligence. One of the complications that alcohol consumption causes is alcoholic coma.

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

Causes of alcoholic coma

Ethanol or alcohol, affecting the human body, causes alcohol poisoning. Despite the fact that many people believe that alcohol can improve your mood and relaxes you, this is only the first phase of the effect of alcohol. Then comes drowsiness, indifference, and later those brain functions that provide vital processes in the body are inhibited.

Alcoholic coma can occur if the alcohol content in the blood is 3%, this 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 drunk dose 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 cannot drink alcoholic beverages on an empty stomach);
• amount of alcohol consumed ( small doses alcohol is excreted through sweat, urine, and breathing; 90% of it is decomposed in the liver);
• strength of alcoholic drink (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 drinking alcohol varies from person to person, but these are the most common indicators. There are people in whom an alcoholic coma occurs even with smaller amounts of ethanol in the blood, while for others the dose should be higher. In addition, dense, fatty foods slow down absorption into the blood and alcohol is eliminated before its concentration reaches lethal levels.

Stages of development of alcoholic coma

What is an alcoholic coma? How can you tell if a person is developing a coma? Alcoholic coma is a condition when, while drinking alcohol, a person experiences a loss of consciousness; he does not come to his senses even with a strong sound (screaming), slaps in the face, 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, you need to immediately call an ambulance! Signs of an alcoholic coma: lack of consciousness, no reaction to sound, slaps in the face, constricted pupils and the smell of alcohol on the breath.

The first symptoms 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, he does not always understand where he is, he confuses the location of rooms in a familiar place, and cannot find the necessary items. A pale face, weakness, constricted pupils, muscle twitching or convulsions are the first signs of an alcoholic coma.

If at this time you help him empty his stomach by inducing vomiting, give him 5-6 tablets of activated charcoal and lay him on his side, then there may not be a coma. The person will get some sleep. In the morning, of course, you 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 breathing or heart problems, then this condition can be treated at home. It is necessary to provide the patient with peace, as strong sounds and light can cause irritation and headaches. We need to fix it drinking regime- drink a lot of water, juices, mineral water to quickly remove alcohol metabolic products from the body. You can take painkiller medicine.

First aid

When the patient has lost consciousness and does not respond to others, call an ambulance immediately! 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 or respiratory problems? - It’s 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 entered 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 respiratory failure due to aspiration (mucus or vomit entering the respiratory tract) 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 alcoholic coma, urgent first aid includes the following steps.

place the patient on his left side

1. The patient must be placed on his left side. To make his position stable, you need to extend your left arm forward and bend his leg at the knee.
2. Clear your mouth of vomit. It can be done index finger, wrapped in a piece of cloth, if you don’t have a clamp and gauze swabs at hand.
3. Excess mucus or vomit in the nasal passages is removed by emergency doctors using suction, but an ordinary syringe will help with this at home.
4. To prevent your tongue from sticking in, you can tilt your head back and push your lower jaw forward. To do this, press thumbs hands on the corners lower jaw, and press the index fingers on the chin, opening the mouth slightly. Emergency doctors can use a tongue depressor or special air ducts for this.
5. When a patient has convulsions, you need to hold him so that he does not hit nearby furniture.

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

There is also another complication - laryngospasm, when, against the background of irritation by vomiting, the vocal cords sharply contract and the patient cannot inhale. In such a situation, urgent tracheal intubation may be necessary - tracheotomy (a skin incision is made, subcutaneous tissue and trachea to form an opening with 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 are necessary: therapeutic measures.

Consequences of alcoholic coma

With timely and adequate treatment, the patient recovers from an alcoholic coma within 2–4 hours. But even with a favorable course, alcoholic coma causes consequences in the form of bruises and injuries from 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 signs of a coma, call an ambulance; only timely medical assistance can save a person’s life.

Alcohol abuse leads to intoxication, which can result in alcoholic coma. This is a life-threatening condition. If the patient is not helped in time, death is possible. The danger lies in the fact that not only alcoholics fall into it, but also those who drank too much alcohol for the first time. It depends on the individual characteristics the body and its ability to resist alcohol toxins.

Considering the high alcoholism of the population, narcologists believe that the symptoms and signs of the onset of a dangerous ending to drunken feasts should be known to everyone. Awareness will be a salvation for many people, because those around them will have time to call an ambulance. This is the only correct decision in this situation. There are no other options, because at home we can provide effective assistance at comatose impossible.

Consequences of alcoholic coma

Coma in the medical sense means a person is between life and death. He remains unconscious, breathing is impaired, reactions are weakened or absent, the pulse becomes uneven, temperature regulation fluctuates. The patient's comatose status is considered to be near death, and he is provided with care in a hospital setting in the intensive care unit.

Alcoholic coma occurs due to poisoning as a result of inhibitory processes in the brain - the cortex, spreading to the subcortex and moving to other parts of the central nervous system. Painting pathological process represents a number of dangerous functional changes:

• blood circulation to the brain is impaired;
• oxygen starvation begins;
• ion exchange is disrupted;
• destabilizes acid-base balance in the tissues of nerve fibers;
• the energy supply to the brain tissue stops.

Treatment is aimed at eliminating all of these phenomena. For this purpose, intensive therapy is used to stop the collapse in the activity of systems and organs. In alcoholics, the respiratory and swallowing functions are first restored so that he does not suffocate and is able to swallow saliva and vomit, which provoke suffocation.

If a person collapses, then his striated muscles are compressed by his own body weight, which ends in the destruction of their fibers. The surrounding muscles become swollen and thickened. This condition muscular system provokes tissue degradation and necrosis. After emerging from a comatose collapse, patients experience excruciating pain syndrome throughout the body.

For the respiratory system, the consequences are also catastrophic. Impaired respiratory functions leave those who have suffered from alcohol coma as sick people for the rest of their lives - they progress to diseases such as tracheobronchitis and pneumonia. The nervous system of comatose patients does not recover at all. Even with stage 1, consequences remain in the form of changes in reactions and movements, and those who survived stages 2 and 3 become incapacitated and experience global personality degradation.

Symptoms of collapse

The symptomatic picture of a developing alcoholic coma is manifested by reflex dysfunction, changes in sensitivity, respiratory degradation, and loss of consciousness. If the comatose state is superficial (degree 1), then characteristic pathologies in the activity of the brain and central nervous system begin to appear.

1. The patient stops feeling pain, saliva flows, and problems with urinary incontinence begin.
2. Alcohol intoxication causes increased heart rate, but blood pressure readings are normal.
3. Breathing becomes hoarse, shortness of breath is observed.
4. Muscle tone becomes tense. This is especially reflected in the leg muscles and chewing muscles. As a result, the patient does not speak and has difficulty breathing and walking.

A deeper superficial coma, classified by doctors as stage 2, is characterized by increased blood pressure and the absence of muscle reflexes. Breathing changes, it can be rapid and shallow. Heart rate readings are within a hundred beats.

A deep alcoholic coma is manifested by alarming symptoms of a critical violation of peripheral circulation, acrocyanosis of the skin due to insufficiency of capillary blood flow. For this reason, the legs, fingers, face in the area of ​​the nasolabial triangle turn blue, ears. There is a decrease in temperature to 35 degrees, the pulse is weak, thread-like, and the beat is rare. Respiratory function is disrupted, signs of lack of moisture in the body appear. Dehydration occurs due to an imbalance of water-salt metabolism.

Stages of development

Alcotoxin poisoning causes disruption of the activity of the centers of the nervous system. When these pathologies become deep enough, the patient’s reactions to what is happening weaken or are absent, and the person loses consciousness. This means that the drinker has more than three ppm of alcohol in his blood, and doctors note the onset of an alcoholic coma, which can be of three degrees.

1 superficial degree of coma determined by external signs- constricted pupils, impaired facial expressions, but the reaction to light is not lost and the response to ammonia is clear. First aid consists of gastric lavage, after which clarity of consciousness returns.

As the therapeutic effect increases, the level of alcohol in the blood increases to five ppm, and the toxin is introduced into systems and organs at the cellular level. If the concentration does not rise above 5 ppm, then you can get by with recovery from a coma at home. The comatose state, called resorption, will last up to 6 hours. Then you will begin to feel better. During resorption, the blood contains 4 ppm of ethyl alcohol.

2 superficial degree of coma has the following characteristics:

• muscle relaxation;
• weak or no response to ammonia;
• gastric lavage does not provide relief;
• the alcohol concentration reaches 6.5 ppm.

The duration of the 2nd degree of coma, called elimination, is 12 hours, then, as a result of the breakdown of alcohol, its content begins to decrease.

3 deep degree coma- the most dangerous condition. This is severe intoxication with all the ensuing consequences.

1. Absence of muscle-tendon reflexes.
2. There is no reaction to pain or tactile influences.
3. The patient does not react to light, the pupils are constricted.
4. Breathing is unstable and intermittent.
5. Cramps and muscle spasms occur.
6. The concentration of ethyl alcohol is within 7.5 ppm.

The second and third degree of coma requires emergency hospitalization. Removal from it is possible only in a hospital setting with the necessary equipment and professional care.

Duration of collapse

On average, a comatose state in alcoholics can last from several hours to weeks and months. There are cases of being in a coma for up to several years. But most often in the first degree, the patient comes to his senses in 6-8 hours, in the second degree it takes unconsciousness It will take from 12 hours to a day.

A deep alcoholic coma can last from one to three weeks. The period of unconscious sleep depends on the depth of changes that have occurred in the brain cells and on the strength of the body’s resistance to intoxication. The longer the dangerous dream, the more negative consequences the patient will have. After emerging from a coma, disturbances in motor functions, speech, memory, intelligence, and development are possible. mental illness. Cases are not uncommon fatal outcome.

How to treat

For relatives of an alcohol addict, it is advisable to know the principles of providing first aid when a person falls into a coma. Independent measures that can prevent tragic consequences, must be undertaken quickly. The algorithm of their actions is as follows:

• With superficial coma important has the patient's position, he should be placed on an elevation on his side with a slope on his stomach. Place your head so that it hangs slightly. This will prevent suffocation.
• The patient should not be left in the cold. Under the influence of alcohol, his temperature regulation is disrupted, and hypothermia may occur. It is best to move it to a warm room or warm it with blankets.
• Moisten the swab with ammonia and let the patient smell it. This reduces the risk of loss of consciousness.
• To improve his condition, he must drink more, the drink must be warm. Sweetened tea and milk are suitable for this.

It is imperative to give something to drink; if the patient refuses, persuade him. The body needs to restore fluid balance, since dehydration occurs during heavy drinking.

If the coma is deep, then first aid is provided in the form of resuscitation measures. If you know how to do artificial respiration, start it immediately. Indirect cardiac massage will also help save the patient’s life.

As a rule, in this state the patient can no longer swallow, does not react to his surroundings, and is in a state similar to unconscious sleep. The danger is that he may not wake up. Your task is to call an ambulance without delaying a single minute.

Treatment begins with blocking the flow of toxins from the digestive organs into the blood. To do this, the stomach is cleared of contents by lavage. And then detoxification begins with the help of droppers with vitamin complex B1, B6 and C, glucose, insulin, soda in saline solution. C-vitamin prevents the transformation of ethyl alcohol into acetaldehyde, which puts a barrier to the entry of ethanol into the blood.

Then measures are taken to prevent drooling, since saliva can enter the trachea, for this an injection of atropine is given. Caffeine injections help support the heart. Ventilation of the lungs and restoration of stable breathing is carried out by clearing the esophagus of vomit and moving the head back, putting on an oxygen mask.

At the next stage, rinsing is repeated using a nasogastric tube and activated carbon to adsorb toxic substances. The main therapeutic drugs for eliminating vascular and cardiac pathologies are glucose and B1.

Restoration of health is possible only with a coma that lasted for 6-8 hours, and abstinence from alcohol must be complete. With a longer coma (12 hours), it is more difficult for the patient to recover. The primary focus of therapy should be on the heart and vascular problems, you need to restore circulatory functions as quickly as possible.

Taking vitamin-mineral complexes will help stabilize intake nutrients into the body and water-salt balance, will relieve dehydration. The patient is prescribed medicines to activate the functions of the brain, liver, and gastrointestinal tract.

The destructive effects of alcohol during a coma are exacerbated, so deal with it dangerous condition need the help of professionals. The drug treatment clinic has everything necessary medications and equipment to prevent any unforeseen circumstances during resuscitation. Timely contact with specialists gives a chance of survival even in a deep alcoholic coma.

Alcoholic coma is characterized by a weakening or lack of response to external irritations, extinction of reflexes, and prolonged loss of consciousness. Occurs when consuming an excessive amount of an alcohol-containing product. The risk of death is high, since in a comatose state there is a drop in blood pressure and depression of the respiratory center.

Causes

The dose of alcohol at which alcoholic coma occurs depends on general well-being, digestive and excretory systems, gender, age, weight of the patient. For example, 70% healthy men over 30 years old and weighing more than 80 kg, a coma occurs if you drink more than 450 ml of vodka. Risk factors are also taken into account: the likelihood of loss of consciousness increases when consuming a low-quality product, having traumatic brain injuries, or combining alcohol with medications.

Coma occurs due to the effect of an alcoholic product on the brain. Bilateral diffuse damage to the cortex and brain stem occurs, the reticular formation, responsible for maintaining muscle tone. As a result, hypovolemia (decrease in circulating blood volume), hypoglycemia (drop in blood sugar), and inhibition of metabolic processes develop.

Symptoms

When helping a patient in an alcoholic coma, doctors face a serious difficulty - immediate action is required, but this type comatose state is similar to loss of consciousness of a different origin. Symptoms of alcohol poisoning overlap with the signs of:

• drug intoxication;
• traumatic brain injuries;
• meningoencephalitis;
• hypertension;
• hypoxic shock (coma due to heart failure, obstructive pulmonary diseases, anemia).

The listed pathologies require different treatment measures, but there is no time for instrumental and laboratory differential diagnosis (when saving a patient who has fallen into a coma, minutes count). The ambulance crew has to take quick solutions based on external symptoms.

A clear symptom of an alcoholic coma is the patient’s unconscious state combined with the smell of ethyl alcohol in the patient’s exhaled air. Other signs overlap with manifestations of coma of non-alcoholic origin (even the presence of alcohol in the patient’s blood is not always proof that it was because of it that pathological inhibition of the central nervous system occurred).

Degrees of the disease

Alcohol coma goes through three stages. If there are no complications, then the matter is limited to the first stage (superficial), lasting less than 2 hours. The difficult stage lasts 2–4 hours. A deep coma is dangerous, since the patient can be brought out of it only in one case out of ten.

• 1st degree.

Due to a violation of the cortical-subcortical functions of the brain, the patient loses consciousness, muscle hypotonia occurs, and there is no reflex response to painful stimuli. Characterized by involuntary movements resembling convulsions during epileptic seizure(trembling of arms, legs, turning of the head, rolling of the eyes).

At the 1st stage of alcoholic coma, body temperature and blood pressure are within normal limits, tachycardia is moderate (80–100 beats), weak proprioceptive (tendon) reflexes remain, the pupils constrict when the light beam is directed. If you give cotton wool with ammonia a whiff, an involuntary facial reaction will occur. The concentration of ethyl alcohol in a superficial comatose state in the blood is 2–5.5%, in the urine – 4–7.5%.

• 2nd degree.

In addition to the suppression of cortical-subcortical functions of the brain, in the second stage of coma, disinhibition of the brainstem and spinal centers occurs. Tendon reflexes stop appearing. The pupils of the eyes react poorly to light. There is no facial reaction when presenting cotton wool with ammonia.

At the second stage of alcoholic coma, hypertonicity of the upper and lower limbs(looks like cramps). Breathing is weak, body temperature drops, pulse is less than 80–90 beats. The concentration of ethyl alcohol in the blood is 2.5–6.5%, in the urine – 2.5–8%.

• 3rd degree.

In the stage of deep alcoholic coma, the pupils do not react to light. Corneal and pharyngeal reflexes are absent. The muscles are severely hypotoned. Only the Babinski reaction is preserved (extension of the toe during stroke stimulation of the outer arch of the sole). Body temperature is greatly reduced (up to 36–35 degrees), skin bluish color(due to insufficient blood supply to small capillaries). The respiratory rate does not exceed 7–10. Mandatory arterial hypotension(less than 100/60).

Diagnostic measures

In the first hours of an alcoholic coma, immediate action is required, time to instrumental diagnostics No. The doctor takes measures to select emergency measures, based on the data from the external examination of the patient. A blood test is carried out after surgical detoxification (this is regulated by Order of the Ministry of Health No. 40 “On the organization of chemical and toxicological studies in the presence of alcohol and toxic substances in the body”).

Detailed chemical and toxicological tests, CT scan of the brain, and chest X-ray are performed when the patient cannot be brought out of a superficial coma and a complex or deep stage of coma occurs. Be sure to determine the CBS, the level of sodium, potassium, calcium, chlorides in the blood serum, and also carry out ALAT and ASAT tests. Additional is the determination of the level of myoglobin, creatine kinase (if there is a suspicion of head injury or spinal cord), clinical analysis cerebrospinal fluid, detection of ketone bodies. These are the measures differential diagnosis, allowing you to filter out or confirm not alcoholic reasons depression of the central nervous system.

First aid

If a patient develops signs of a severe coma, the task of loved ones is to immediately call an ambulance. Urgent Care rides for 15–30 minutes, during this time you need to:

• Place the patient in a position in which the risk of choking on vomit is minimal ( better belly down, head to the side).
• When a coma occurs, the temperature drops, so the patient should be covered with a blanket (putting him in an ice bath for alcohol poisoning is prohibited).
• Give a cotton swab soaked in ammonia a sniff (sometimes this is enough to bring you out of a superficial coma).
• If the pulse is depressed, carry out resuscitation measures - first aid consists of artificial respiration, indirect massage hearts.

When a team of doctors arrives for an emergency call, they carry out treatment on site and in the car while transporting the patient. The algorithm depends on the symptoms of coma:

• For respiratory obstruction - mechanical ventilation or endotracheal ventilation.
• In case of unsatisfactory hemodynamics - intravenous administration Dopamine.
• For detoxification, removal acute symptoms– gastric lavage is performed, Glucose 50%, Thiamine 100 mg, Naloxone 0.4 mg are administered.
• For status epilepticus, Phenytoin is administered intravenously.

Treatment

In the hospital, the patient undergoes several gastric lavage sessions using a nasogastric tube. Then enter Activated carbon for the adsorption of alcohol toxins. When transitioning from a superficial to a deep coma, the patient is administered Metadoxil 600 mg 3 times a day. Other required medications are:

• Saline solutions (sodium bicarbonate, meglumine sodium succinate, multicomponent saline solutions).
• Dextrose intravenous solution.
• Vitamins B1, B6, C, PP.

To reduce salivation, a patient in a coma is given an injection of atropine (the drug prevents saliva from flowing into the trachea). Caffeine is administered to the patient to support heart function.

The patient in the hospital is under the supervision of a toxicologist, a therapist (pediatrician if poisoning from alcoholic products occurred in a child), and an anesthesiologist-resuscitator. Additionally, a neurosurgeon, neurologist, traumatologist, surgeon, infectious disease specialist, cardiologist, and gastroenterologist are involved in the treatment.

Consequences and prevention

After emerging from a coma lasting no more than 4 hours, the patient has a chance to fast recovery health. In 85% of cases, there are no negative consequences of being in a comatose state; the person is released from the hospital after 5 days.

If the alcoholic was unconscious for more than 4 hours, then complications occur in half of the cases. In deep coma lasting more than a day - in 100% of cases. A common post-coma pathology is myoglobinuria, which occurs as a result of prolonged compression of soft tissues and muscles by one’s own body weight, complicated by slow blood flow. Neuritis and muscle atrophy develop.

Another complication is acute renal failure accompanied by hyperkalemia, hemorrhagic syndrome, hypochromic anemia. In half of the cases, after leaving a coma, deviations in work are observed of cardio-vascular system, CNS.

To prevent complications, doctors prescribe vitamin complexes and drugs to improve liver function, blood circulation, and brain function. Important: after recovery from a coma, it is forbidden to take alcoholic products. If this condition is not met, there can be no talk of recovery.

Test: Check the compatibility of your medicine with alcohol

Enter the name of the drug in the search bar and find out how compatible it is with alcohol