STROKE by pengtt

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									                 ALCOHOL OVERDOSE

PATHOPHYSIOLOGY
      Alcohol is a depressant. Ethanol, the ingestible form of
      alcohol, is the most commonly abused drug in the United
      States. In smaller doses alcohol appears to stimulate the
      patient because of its effects on the patient’s psychological
      inhibitions and judgment. Malnutrition is associated with
      alcohol abuse because foods, which contain vitamins and
      proteins, are replaced with alcohol (special concern for
      thiamine vitamin B3).

SIGNS AND SYMPTOMS OF ALCOHOL OVERDOSE
   Smell of intoxicants on breath
   Mood ranges from euphoria to violence
   Slurred, loud, inappropriate speech
   Ataxia (Poor physical coordination)
   Nystagmus (Abnormal eye movements)
   Tachycardia
   Distortion of sensory preceptors
   Altered level of responsiveness/confusion/coma
   Nausea and vomiting
   Incontinent
   Lack of memory

SIGNS AND SYMPTOMS OF SEVERE ALCOHOL OVERDOSE
   Hallucinations
   Hypotension
   Slow/labored respirations
   Dehydration
   Seizures
                                      TREATMENT GOALS
EMT BASIC
    Perform Initial Assessment, Focused history and physical exam
    Aggressive airway management
    High flow oxygen
    If unconsciousness and no gag consider Combitube
 Cardiac Monitoring (Started enroute to hospital)
EMT INTERMEDIATE
 I.V. (18G or larger)
 Check blood sugar, Treat if necessary
 If patient is unconscious and other drugs may have been used, consider
  Narcan 0.1 to 2.0mg I.V.
 Endotracheal or Combie Tube intubation if severe respiratory depression
  and no response to Narcan and normal blood sugar
EMT PARAMEDIC
   If malnourished individual consider Thiamine 100mg IV/IM
   The symptoms of thiamine deficiency, particularly
    congestive heart failure, can be precipitated by the
    administration of dextrose, which increases metabolic rate
    and thiamine demand (Wernicke’s Syndrome). Thus
    thiamine, usually 100mg I.M. or I.V. should be administered
    before, with, or within a short period of time after
    dextrose for at risk patients

HOSPITAL
    Medically evaluate the patient and provide safe environment for patient
     to detoxify. Based on patient’s condition, police involvement, and many
     other factors, the client may be sent to Detox, the Dane Co Jail, or home
     to detoxify. In more chronic patients, they need to be in centers that
     can control withdrawal symptoms using drugs like diazepam (Valium) and
     chlorodiazepoxide (Librium)

                                                    Sources:
1.   American College of Emergency Physician’s Paramedic Field Care Textbook. 1997
2.   Emergency Medicine – A Comprehensive Study Guide, ACEP 5th edition, 1999
3.   Brady’s Paramedic Emergency Care, 3rd edition. 1997
                                                Revised 01/2000

								
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