Intoxicated.

Intoxicated. In certain doses, alcohol relieves mental stress, improves mood, creating a feeling of looseness and fun. These sensations for which people and drink alcohol, time, and with increasing doses of alcohol are replaced by the state of excitation of the loss of self-control and critical assessment of the situation, and sometimes malice, aggression or depressed mood. It is in this state of drunken commits antisocial acts up to serious crime. Status of depression and depression sometimes resulting in suicide drunk. For a single large doses of alcohol may develop severe alcohol poisoning. Systematic abuse of alcohol is addicted to alcohol.

Upon receipt of alcoholic beverages as alcohol absorption from the stomach and intestines its concentration in the blood increases, reaching a maximum (in single receipt) at 2 o'clock, and then gradually decreases; 10% alcohol excreted through the lungs, kidneys and skin in an unmodified form, the remaining quantity is oxidized by the liver. It was found that traces of alcohol intake single healthy person stored in the body for 2 weeks, although the blood alcohol disappears after 4 to 5 hours, and after a single large dose of reception -. 12 h The highest concentration of alcohol originally noted in the liver and muscles, then it penetrates the central nervous system - first in the subcortical structures and the cerebellum, then the cerebral cortex, which is stored the longest. Large doses of alcohol cause inhibition of the cerebral cortex and the vital centers of the medulla oblongata (respiratory, vasomotor), which results in severe respiratory and circulatory disorders - a major cause of death in severe alcoholic intoxication.

The rate of appearance of the first signs of intoxication depends on the strength of the drink and food of the degree of filling of the stomach. The degree of intoxication is determined by the amount taken alcohol per 1 kg of body weight, individual tolerance and the state of his body during the reception of alcohol. When fatigue, exhaustion, small amounts of alcohol can cause severe intoxication; in a state of mental stress intoxicating effects of alcoholic beverages decreased. Children, the elderly, people suffering from diseases of the liver, stomach, certain endocrine disorders, are particularly sensitive to alcohol.

Conventionally, there are three degrees of drunkenness: light, medium degree of intoxication and heavy. The content of alcohol in the blood in mild intoxication is 0.5 to 1.5% of at moderate intoxication - 1.5 -2.5% 0, in severe - 2.5 -3% of. By increasing the blood alcohol content of 3-5% of developing severe poisoning which can be fatal.

Light intoxication is characterized by mood elevation, complacency, a desire to communicate. This reduces the ability to concentrate, associations are superficial, inconsistent, accelerated. Judgments are lightweight, overestimated their own capabilities. Disturbed perception of time and space, so dangerous intoxication when working with moving machinery, transport. Objectively, there is expansion of peripheral vascular (porrzovenie, skin warming, bright eyes), a decrease in heart rate with an increase in cardiac output (slow full pulse), reducing the tone of the vascular system as a whole (a drop in blood pressure), muscle tone, dysfunction of the cerebellum (the muscles are soft to the touch , inaccurate and slow motion).

When the average degree of intoxication often appears irritability, often with a sense of resentment, discontent, anger, which is reflected in the statements. Perhaps aggressive behavior. Disorders of thought deepened. Quickens the pulse , raises blood pressure; however, peripheral blood vessels are dilated, broken capillary blood flow, so the face becomes red. Violation of the regulation of vascular tone at this stage of intoxication can cause angina, spasm of cerebral arteries. Increases coordination of movements, gradually develop drowsiness, lethargy, comes a deep sleep. Upon awakening marked weakness, heaviness in the head, depressed mood, dissatisfaction with oneself and others, irritability, lack or loss of appetite; difficult comprehension and concentration, impaired motor coordination, slowed the pace of psychic processes.

In severe intoxication impaired orientation in the environment, it slows down and is punctuated by pauses, lost facial expressions. There have vestibular disorders - dizziness , nausea , vomiting . With the increase of drunkenness enhanced impairment of consciousness, until the development of coma, breathing slows down, lowered the tone of the cardiovascular system, develop immobility, muscle relaxation. As a result, death can occur paralysis of the respiratory or vasomotor center. After heavy intoxication mental and neurological disorders are more pronounced. Man does not remember what happened to him in a state of intoxication.

From the ordinary (simple) intoxication should be distinguished so-called pathological intoxication, which is a special form of stupefaction (see. Alcoholic psychoses).

The basis of the examination of intoxication is a clinical assessment of the patient, based on an analysis of its behavior, as well as autonomic and neurological disorders. Objective evidence of the clinical evaluation is to determine the content of alcohol in the blood, urine or saliva by laboratory methods. Applied also various kinds of display devices that allow to detect alcohol in the breath. On examination, the patient's health care professional is important not only to observe the state of intoxication, but to describe it correctly in the medical records that may have in the future a great legal significance. We present information about the appearance of being examined, his behavior, emotional background, speech, vegetative-vascular reactions, able to motor areas. Conducting medical examination itself is often a strong psychogenic factor influencing the physiological and psychological state of the person. In case of doubt (in cases of mild intoxication) it is advisable to carry out the reaction Rapoport, or use the display tube moss-Shinkarenko. Legislation is recommended to use the following conclusions: "Be sober, be signs of alcohol consumption is not"; "The fact of the use of alcohol, but the signs of intoxication are not identified (there are some signs of the action of alcohol in combination with alcohol and breath detection of alcohol in exhaled air by chemical means); "Drunkenness"; "Alcoholic coma"; "The state of intoxication caused by the drug or other substances"; "Sober, but there are violations of the functional state, requiring a suspension from work with a source of danger to health."

In the diagnosis of intoxication should be noted that a similar clinical picture can be observed in a number of serious diseases and pathological conditions - cerebral hemorrhage, myocardial infarction, diabetic coma, etc. In addition, these diseases may develop on the background of light intoxication, and the smell of alcohol. coming from the patient, it is the cause of diagnostic errors.

Help with alcohol intoxication. With an average degree of intoxication is conducted following therapeutic measures: to reduce alcohol intake give the patient drink 2-3 tablespoons of crushed activated carbon (or polyphepane), then (after 10-15 min) washed stomach or cause vomiting; then offering the patient to drink a glass of water with dissolved ammonia (8-10 drops per glass) and intravenously administered 2 mL of a 10% solution of caffeine or kordiamina 40% glucose solution. Then you can put a hot-water bottle at the feet or put mustard. Inside give to drink a laxative: up to 30 g of magnesium sulfate.

In severe intoxication order of medical worker actions should be as follows. You must first eliminate medical complications (primarily - traumatic brain injury), requires intervention, and only then begin to sober up. Stomach washed patient through a thick tube in small portions (300 - 500 ml), warm water (12-15 liters total) with the addition of sodium carbonate or a weak solution of potassium permanganate. Suitable bladder catheterization and inhalation of ammonia. The patient was administered intravenously analeptic mixture consisting of 10 ml of a 0.5% solution bemegrida, kordiamina 1 ml, 1 ml of a 20% solution of caffeine, 1 ml of a 10% solution of metrazole and 17 ml isotonic sodium chloride solution or a 40% glucose solution. When developing breathing disorder is administered intramuscularly or 0.5 ml tsititona lobeline. According to testimony carried tracheal intubation to prevent aspiration of vomit, keep the language glossotilt, suctioned mucus from the pharynx.

In the most extreme "of rescue" cases, you can resort to this method: take over the head lying on his back "dead" a drunken man, so that the palm of the hands were placed on his ears, and then quickly and strongly rub both ears. The rush of blood to the head can lead to drunken mind, and in a moment he will even be able to include your address. Naturally, in the subsequent transition to the complex procedures described above.