Ethanol toxicity: Difference between revisions
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##Ketoacidosis | ##Ketoacidosis | ||
##Lactic acidosis | ##Lactic acidosis | ||
##Epigastric pain (pancreatitis) | |||
==Diagnosis== | ==Diagnosis== |
Revision as of 17:09, 20 May 2013
Background
- AMS that doesn't improve after few hrs is due to alternative cause until proven otherwise
- Blood Alcohol Level
- Correlates poorly with degree of intoxication
- Rate of ETOH elimination is 15-30mg/dL/hr (depending on degree of chronic alcoholism)
Clinical Features
- Classic Features
- Slurred speech
- Nystagmus
- Ataxia
- N/V
- Respiratory depression
- Coma
- Other Features (if malnourished)
- Hypoglycemia
- Ketoacidosis
- Lactic acidosis
- Epigastric pain (pancreatitis)
Diagnosis
- Blood sugar
- BAL
- Appropriate if AMS is due to unknown cause
- Not necessarily required in mild-mod intoxication or if no other abnormality suspected
- Elevated osmolar gap
Treatment
- GI decontamination
- Activated charcoal ineffective (ETOH is too rapidly absorbed)
- Hypoglycemia
- Give glucose immediately (do not have to wait to give thiamine first)
- "Banana Bag"
- IV form is not justified
- Likelihood of vitamin deficiency (except for thiamine) is low
- IVF does not hasten ETOH elimination
Disposition
- Most pts require observation only
See Also
Source
- Tintinalli