The poisoning of alcohol surrogates occupies a leading position in the statistics of all intoxication. Moreover, 98% of patients dying to hospitalization. Understand the cause of such high mortality will help a brief description of Alcoholic Surrogate.

What is alcohol surrogates? What signs of poisoning such an alcoholic fake exist? How to help the victim? What could be the consequences of such intoxication? We will analyze the answers to these questions in this article.

What applies to alcohol surrogates

Alcohol Surrogate Poison international Classification MKB-10 diseases correspond to T51.1 - T52.9 codes.

They are divided into two groups: on those alcohol surrogates, which may contain in their composition ethanol And those that can be without it. The first group includes:

The second group or them is also called "false surrogates" presented:

• methyl alcohol;
• ethylene glycol.

Clinical Symptoms of Alcohol Poisoning Surrogate

Symptoms of poisoning alcoholic surrogates differ depending on which group they relate to. They will be more favorable if these are alcohol surrogates of the first group containing ethyl alcohol, and more severe and dangerous with methanol or ethylene glycol in poisoning, so they should be stopped in more detail.

Symptoms of poisoning with surrogates containing ethyl alcohol

Signs of alcohol intoxication are clinically observed:

• emotional and motor arousal;
• facial redness;
• state of euphoria;
• sweating;
• increased salivation;
• a feeling of mental and physical relaxation.

Then intoxication is replaced by symptoms of alcoholic intoxication. The skin becomes pale. Appear frequent urges To urination. Pupils are expanding, a feeling of dryness occurs in the mouth. The increased mental and physical activity is accompanied by a violation of coordination, movement becomes sweeping. The concentration of attention becomes a reduced sense. Abruptly reduced or there is no criticism of their words and actions.

Symptoms of methanol poisoning (wood alcohol)

Methyl alcohol is quickly absorbed in digestive system. About 75% of the absorbed poison is excreted with breathing, the rest is with urine. The deadly dose is from 50 to 150 milliliters. The main blow in poisoning is to the nervous system and the kidneys. There is a psychotropic effect (pathological changes in psyche) and neurotoxic effect, accompanied, including damage spectator nerves, retina.

So, in poisoning with alcohol surrogates containing methanol, the symptoms arise as follows:

• nausea, vomiting;
• intoxication and euphoria are weakly expressed;
• violation of vision: Flashing of black points before your eyes, the odorility of the vision, diplopia (shots in the eyes) and even blindness;
• externally, such patients with pupils are expanded, sluggishly react to light;
• 1-2 days after poisoning, abdominal pain appear, lumbar, losses in muscles and joints;
• temperatures increase to 38⁰;
• dry skin and mucous membranes;
• reduced blood pressure;
• interruptions in the work of the heart;
• confusion of consciousness;
• excitation attacks accompanied by convulsions;
• as the symptoms increase, the victim falls into someone, the extremities paralysis develops.

Symptoms of ethylene glycol poisoning

Ethylene glycol is also quickly absorbed in the digestive tract. About 60% of the poison is split into the liver, about 20-30% - excreted by the kidneys. Therefore, these authorities will be more likely to suffer until the development of their acute insufficiency. In case of severe poisoning, signs of lesion appear nervous system.

With intoxication, this surrogate alcohol symptoms develop in periods.

1. Early period. It lasts about 12 hours and is characterized by signs of alcohol intoxication with well-being.
2. Toxic damage to the nervous system. There are: nausea, vomiting, headache, thirst, diarrhea, leather and mucous meal becomes bluish. Pupils are expanded, the body temperature rises, difficult breathing, tachycardia, psychomotor excitement appears. Possible loss of consciousness with the development of convulsion.
3. Nephro and hepatotoxic period develops by 2-5 days from the beginning of the disease. There is a clinic of liver and renal failure. The yellowness of the skin appears, which appears first on the cleaners and the latter turn yellow. Character skin itchThe darkening of urine can occur. Renal failure is manifested by a decrease in diuresis up to its absence.

Emergency care for poisoning alcohol surrogates

When suspected poisoning with alcohol surrogates urgent Care It will depend on the initial state of the patient. If the patient is unconscious, then it must be put on a flat solid surface, turn the head of the side so that there is no aspiration by the vomit masses and cause ambulance. In disruption of respiratory and cardiac activity, first cause ambulance, and then the indirect heart massage and artificial respiration are already carried out.

When the first victim in consciousness prefigure help consists of the following actions:

• take the sorbent;
• salt laxative;
• drink enveloping decoction, for example, kissel;
• emergency hospitalization in the hospital.

Treatment of poisoning alcohol in hospital:

1. Washing the stomach through the probe. With intoxication, it is repeated for 3 days by methanol. Give sorbents.
2. Antidote treatment in both cases is the same: five percent ethanol is injected intravenously. With light poisoning, the reception of ethyl 30% alcohol inside is allowed.
3. When poisoning, the ethylene glycol is administered calcium gluconate to neutralize the splitting products of a poisonous substance.
4. A forced diurez is carried out, which is based on the drip administration of a large amount of solutions and diuretic drugs in the absence of a violation of the kidney function.
5. The removal of blood toxins is also carried out by the method of hemodialysis.
6. The introduction of glucose with novocaine, prednisolone, vitamins B and C.
7. In case of methanol poisoning, spinal points are performed.
8. In severe cases of intoxication, ethylene glycol may need a kidney transplant.

Consequences of alcoholic surrogate poisoning

Despite the fact that the course in poisoning alcohol surrogates containing ethyl alcohol, more favorable, consequences can be very serious. The forecast is determined by the amount of feeding fake, and more by the timeliness rendered medical care. If the patient suffered from chronic alcoholism, poisoning occurs heavier and deaths more than those who did not have alcohol addiction.

When intoxicating, methanol is possible complete loss of vision, which, after the elimination of the poison from the body is not restored. Surrogates based on ethylene glycol lead to kidney failure. Such patients are mainly dying.

The problem of poisoning alcohol surrogates, unfortunately, remains relevant today. Many faces this disease, so knowledge of signs of such intoxication will help not only provide an emergency assistance to the victim, but also save him life!

Eliminate 3 degrees of intoxication:

- easy- blood alcohol concentration of up to 2% , which corresponds to 0.5-1.5 ml of pure ethanol per 1 kg of human body weight;

- average- 2-3% of alcohol is revealed in the blood, i.e. ethanol adopted 1.5-2.5 ml per 1 kg of tp mass;

- heavy- It occurs at the concentration of ethanol in blood 3-5% o and more, which corresponds to 2.5-4.5 ml of alcohol per 1 kg of mass. In severe, intoxication is developing a coma, which may be the immediate cause of death along with asphycia, due to the deep aspiration of vomit, acute heart failure.

Upon admission to the hospital in a patient with suspicion of alcohol poisoning, it is necessary to take blood (urine) to identify ethanol, with filling "directions to a chemical and toxicological study" in form 452 / y-06 (in accordance with the Order of the Ministry of Health and Social Development of Russia dated 01.01.2001 № 40). In determining the content of ethanol in the blood and urine at the corpse to assess the severity of alcohol intoxication (poisoning), special tables should be used (see guidelines for forensic medicine), which take into account the time passed after the time of the intended use of alcohol and after death.

In the case of death from acute alcohol intoxication - ethanol poisoning (ethyl alcohol) and its surrogates, the latter is always exhibited in a diagnosis as a major disease (independent nosological unit) - the initial cause of death. Alcohol poisoning in some cases is developing in patients with background diseases - Hai or chronic alcoholism. Final clinical diagnosis Ethanol poisoning and / or its surrogates requires the direction of the body of the deceased to forensic dissection, therefore, the principles of formulation of the forensic diagnosis in such a situation in these recommendations are not considered and set forth in relevant forensic regulatory documents.

Full use of alcohol, alcohol abuse (F10.1), indicates its regular, systematic use (drunkenness is familiar, domestic) in doses, when the body is not able to fully process alcohol and its metabolites leading to a state with the development of polyorgan morphological manifestations (alcohol Complemenopathy), therefore, it can be designated as a disease and corresponds in essence terms "chronic alcoholic intoxication" (HAI).

Hai is a group concept, in which in the diagnosis, depending on the severity of the lesion and clinical and morphological manifestations, the characteristic alcohol defeat of one of the organs, which corresponds to nosological forms on the ICD-10 and in cases of death, seems to be the initial cause of death.

The diagnosis is not allowed to replace the terms "toxic" or "alimentary" term "alcoholic" with appropriate nosological units from a group of alcohol whistering (alcoholic cirrhosis of the liver, alcoholic cardiomyopathy, alcohol encephalopathy, etc.).

A variety of somatic, neurological and mental disorders (nosological forms and syndromes) with alcohol disease in the ICD-10 are reflected in different classes, rubrics and codes, which are grouped in Table 1.

Table 1

For other alcohol organic pathology, such as published liver losses with portal hypertension syndrome, IGA-jade, often caused by alcohol, appropriate ICB-10 codes presented without indicating the alcoholic nature of the pathological process.

Symptoms arising from the use of true surrogates depend on impurities that are part of the alcohol-containing liquid. After receiving the hydrolysis alcohol of manifestations, the same as after the use of too much dose of conventional alcohol: nausea, vomiting, headache, dizziness, dry mouth. Hydrolysis alcohol is more toxic than ethyl, therefore, signs of poisoning of alcohol surrogates are observed after receiving a smaller amount of alcohol.
In patients with severe alcoholism, poisoning with alcohol surrogates often occurs when taking alcohol-containing heart rate. The composition of such funds includes cardiac glycosides provoking bradycardia. With systematic use or reception of a large dose, acute heart failure can develop. In the outer alcohol-containing means, anesthesine is often added, which blocks the ability of blood to deliver oxygen to organs and tissues. The poisoning of alcohol surrogates is manifested by symptoms of oxygen starvation. The mucousse becomes bluish, the blood acquires a brown tint.
The taste and smell of methyl alcohol - the same as in ethyl. Female outcome can occur after use of only 100 ml. Individual sensitivity varies, therefore, after eating the same dose, one patient can observe a heavier poisoning of alcohol surrogates than that of another. The severity of poisoning also depends on whether the ethanol antidote is at the same time, which is the antidote of methanol - some alcoholics binds methyl ethyl alcohol to avoid poisoning.
However, such attempts to save are conjugate with immediate risk to life. Methanol itself is not poisonous, but when it is splitting in the body, strong poisons of formaldehyde and formic acid are formed. When using a large dose, the signs of poisoning with alcohol surrogates appear practically lightning, death occurs after a few hours. When taking a small dose there is a hidden period during which the patient feels satisfactorily.
Light form The poisoning of alcohol surrogates is manifested by nausea, repeated vomiting, headache, dizziness, pain in the epigastrium, nonresopable disorders of vision - flashes flies, violation of the clarity of perception ("can be seen how through the fog"). Symptoms are saved for several days, and then gradually disappear. In poisoning by the surrogates of alcohol, the average severity of manifestations are similar, but all the symptoms are pronounced more brightly. After 1-2 days, the patient loses his eyesight. Subsequently, the vision is partially restored, but then the worsen again. Such poisoning usually do not pose a threat to life, but may entail violations with disability disabilities.
With severely, pronounced typical symptoms of alcohol surrogates, drowsiness and stumps arise. A few hours later there are growing thirst, pains in the legs, dryness and sinusiness of mucous membranes, rhythm disorders, tachycardia and increased blood pressure. Subsequent tachycardia is replaced by bradycardia, blood pressure drops. There is a confusion of consciousness, cramps and psychomotor arousal are possible. With particularly severe poisoning of alcohol surrogates, the time segment between the appearance of the first symptoms and the occurrence of pronounced violations of life is only 2-3 hours. The result becomes a coma and death as a result of the stopping of breathing and violations of the heart.
Another often encountered poisoning occurs when the brake fluid is used containing ethylene glycol. Female dose, as in with methanol poisoning - only 100 ml. The cause of poisoning is the formation of poisonous intermediate products of decay of ethylene glycol, in particular, oxalic acid, which provokes acidosis and has a destructive effect on the kidneys as a result of the formation of sodium oxalate crystals.

What is alcohol surrogates? What signs of poisoning such an alcoholic fake exist? How to help the victim? What could be the consequences of such intoxication? We will analyze the answers to these questions in this article.

What applies to alcohol surrogates

The poisoning of alcohol surrogates in the international classification of diseases of the ICD-10 corresponds to the codes T51.1 - T52.9.

They are divided into two groups: on those alcohol surrogates, which may contain ethyl alcohol in their composition and those that can be without it. The first group includes:

1. Boutique alcohol. Death occurs after the adoption of only 30 milliliters.
2. Hydrolysis and sulfite alcohols that are obtained from wood. They are toxic than ethanol due to the presence of a small number of methyl alcohol.
3. Denate or technical alcohol. Contains some wood alcohol and aldehyde.
4. Politura contains several types of toxic alcohols.
5. Morilka, together with ethanol, has dyes, from which the skin and mucous membranes of the patient become blue color.

The second group or them is also called "false surrogates" presented:

• methyl alcohol;
• ethylene glycol.

Clinical Symptoms of Alcohol Poisoning Surrogate

Symptoms of poisoning alcoholic surrogates differ depending on which group they relate to. They will be more favorable if these are alcohol surrogates of the first group containing ethyl alcohol, and more severe and dangerous with methanol or ethylene glycol in poisoning, so they should be stopped in more detail.

Symptoms of poisoning with surrogates containing ethyl alcohol

• emotional and motor arousal;
• facial redness;
• state of euphoria;
• sweating;
• increased salivation;
• a feeling of mental and physical relaxation.

Then intoxication is replaced by symptoms of alcoholic intoxication. The skin becomes pale. Frequent urge to urination appear. Pupils are expanding, a feeling of dryness occurs in the mouth. The increased mental and physical activity is accompanied by a violation of coordination, movement becomes sweeping. The concentration of attention becomes a reduced sense. Abruptly reduced or there is no criticism of their words and actions.

Symptoms of methanol poisoning (wood alcohol)

Methyl alcohol is quickly absorbed in the digestive system. About 75% of the absorbed poison is excreted with breathing, the rest is with urine. The deadly dose is from 50 to 150 milliliters. The main blow in poisoning is to the nervous system and the kidneys. The psychotropic effect arises (pathological changes in psyche) and neurotoxic effect, accompanied, including damage to the visual nerves, retina.

• nausea, vomiting;
• intoxication and euphoria are weakly expressed;
• violation of vision: Flashing of black points before your eyes, the odorility of the vision, diplopia (shots in the eyes) and even blindness;
• externally, such patients with pupils are expanded, sluggishly react to light;
• 1-2 days after poisoning, abdominal pain appear, lumbar, losses in muscles and joints;
• temperatures increase to 38⁰;
• dry skin and mucous membranes;
• reduced blood pressure;
• interruptions in the work of the heart;
• confusion of consciousness;
• excitation attacks accompanied by convulsions;
• as the symptoms increase, the victim falls into someone, the extremities paralysis develops.

Ethylene glycol is also quickly absorbed into

digestive tract. About 60% of the poison is split into the liver, about 20-30% - excreted by the kidneys. Therefore, these authorities will be more likely to suffer until the development of their acute insufficiency. With severe poisoning, signs of damage to the nervous system appear.

1. Early period. It lasts about 12 hours and is characterized by signs of alcohol intoxication with well-being.
2. Toxic damage to the nervous system. There are: nausea, vomiting, headache, thirst, diarrhea, leather and mucous meal becomes bluish. Pupils are expanded, the body temperature rises, difficult breathing, tachycardia, psychomotor excitement appears. Possible loss of consciousness with the development of convulsion.
3. Nephro and hepatotoxic period develops by 2-5 days from the beginning of the disease. There is a clinic of liver and renal failure. The yellowness of the skin appears, which appears first on the cleaners and the latter turn yellow. Skin itching is characterized, darkening of urine can occur. Renal failure is manifested by a decrease in diuresis up to its absence.

Emergency care for poisoning alcohol surrogates

With suspected alcohol surrogate poisoning, emergency assistance will depend on the initial state of the patient. If the patient is unconscious, then it must be put on a flat solid surface, turn the head of the side, so that there is no aspiration by the vomit's masses and cause ambulance. In disruption of respiratory and cardiac activity, first cause ambulance, and then the indirect heart massage and artificial respiration are already carried out.

• take the sorbent;
• salt laxative;
• drink enveloping decoction, for example, kissel;
• emergency hospitalization in the hospital.

Treatment of poisoning alcohol in hospital:

1. Washing the stomach through the probe. With intoxication, it is repeated for 3 days by methanol. Give sorbents.
2. Antidote treatment in both cases is the same: five percent ethanol is injected intravenously. With light poisoning, the reception of ethyl 30% alcohol inside is allowed.
3. When poisoning, the ethylene glycol is administered calcium gluconate to neutralize the splitting products of a poisonous substance.
4. A forced diurez is carried out, which is based on the drip administration of a large amount of solutions and diuretic drugs in the absence of a violation of the kidney function.
5. The removal of blood toxins is also carried out by the method of hemodialysis.
6. The introduction of glucose with novocaine, prednisolone, vitamins B and C.
7. In case of methanol poisoning, spinal points are performed.
8. In severe cases of intoxication, ethylene glycol may need a kidney transplant.

Consequences of alcoholic surrogate poisoning

When intoxicating, methanol is possible complete loss of vision, which, after the elimination of the poison from the body is not restored. Surrogates based on ethylene glycol lead to kidney failure. Such patients are mainly dying.

The problem of poisoning alcohol surrogates, unfortunately, remains relevant today. Many faces this disease, so knowledge of signs of such intoxication will help not only provide an emergency assistance to the victim, but also save him life!

Alcohol poisoning and its surrogates? Symptoms and signs. First aid with alcohol poisoning, what to do?

Alcohol Surrogate Poison Code on ICD 10

Poisoning alcohol surrogates

Acute poisoning of alcohol surrogates: signs and symptoms, diagnosis, treatment

doctor-Medic.ru.

Ethanol poisoning and alcohol surrogates

Ethanol (ethyl alcohol), the well-known component of alcoholic beverages, is a transparent bat water-soluble liquid with the smell characteristic of alcohols.

It is used extremely widely both in purified and as part of many technical fluids, cosmetics, etc. Poisoning causes with massive admission to the body.

ICB-10 T51 Toxic alcohol effect T51.0 Toxic effect of ethanol T51.1 Toxic action of methanol T51.2 Toxic effect 2-propanol T51.3 Toxic effect of fusion oils T51.8 Toxic effect of other alcohols T51.9 Toxic action of unspecified T52 alcohol toxic The effect of organic solvents T52.3 Toxic effect of glycols T52.4 Toxic effect of ketones T52.8 Toxic effect of other organic solvents T52.9 The toxic effect of organic solvents unspecified.

EPIDEMIOLOGY

Epidemiology The fourth part of all acute poisoning is alcohol poisoning. More than 60% of all death poisonings also belong to this group.

Causes Risk factors: ■ Chronic alcoholism (about 90% of alcohol hospitalized with acute alcohol poisoning suffers from chronic alcoholism). ■ Use of alcoholic beverages on an empty stomach (food in the stomach slows down the absorption of alcohol). ■ peculiar lifestyle: frequent measures accompanied by a feast; Availability of alcohol, especially cheap. ■ Alcoholism in the family. The deadly concentration of ethanol (ethyl alcohol) in the blood - 5-8 g / l, deadly motherwise dose - 4-12 g / kg (300-500 ml of 96% ethanol), however, these indicators of unequal people in different people are largely dependent on the acquired alcohol tolerance. Ethanol easily penetrates through fabric membranes, quickly absorbed in the stomach (20%) and thin intestine (80%). On average, after 1.5 hours, its blood concentration reaches the maximum level. The substance acts as an electoral depressant CNS in low doses and as a common depressant in high, has a psychotropic (narcotic) effect, which is accompanied by the suppression of the excitation processes in the CNS due to changes in the metabolism of neurons, violation of the function of mediator systems, slowing the processes of oxygen disposal. In a pathogenesis, metabolic toxicosis and acidosis (accumulation of ethanol biotransformation products) plays a significant role. The main endogenous product is a poisonous acetaldehyde, formed with all variants of the oxidative degradation of ethyl alcohol. If the aldehyde of dehydrogenase (an enzyme participating in alcohol metabolism) does not have time to transform it into acetate, a picture of pronounced intoxication is developing. Acetaldehyde disrupts the adrenaline circuit and other catecholamines in the brain and on the periphery, is striking the SCC, the liver, kidneys. Especially subject to toxic action Alcohol face of Asian origin, since most of them in the body aldehyde dehydrogenase is in inactive form. In such a situation, even small doses of alcohol are able to cause serious poisoning.

DIAGNOSTICS

Diagnosis Anamnesis and physical examination of alcohol poisoning develops stadium. The clinic depends on the dose (Table 9-7). On the acute poisoning of ethanol, they say when the state of a person who took a large dose of alcoholic beverages is sharply deteriorating, there are violations of consciousness, the ability to walk, perceive the surrounding, is the stupor and coma.

Table 9-7. Stages of acute action of alcohol (alcoholic intoxication) in indispensable persons (with changes in K.M. Dubovski)

The symptoms of the alcohol coma is nonspecific and is an option of a narcotic coma (see the article "Coma"). Typically, aspiration violations are characteristic (the price of language, hypersion and bronchory, aspiration of the vomit), Stridor, Tahipne, Akricyanoz, swelling of the cervical veins, are possible large-tag wheels in the lungs, the expansion of pupils. There is a hypothermia. In the absence of medical care, the main cause of death on chipboard - Breath disorders. Different difficult complications may be observed due to the lesion of myocardium up to necrosis, acute cardiac death. In case of poisoning with ethanol in children, in addition to the loss of consciousness, acidosis, hypoglycemia (especially in children under 5) and hypokalemia come to the fore. In young children, percutaneous intoxication is described when applying alcohol compresses.

Additional examination

Additional examination ■ ECG: decreased ST segment, negative Teeth T, extrasystolia; With alcohol cardiomyopathy, persistent rhythm and conductivity disorders are possible, signs of damage to myocardium. ■ During the first examination of the patient, it is advisable to make a fence venous blood For subsequent chemical analysis on the content of alcohol, which may be required in the future (in the vial or tube between blood and the plug, there should be no free space; otherwise, the result of the study will be understated due to the evaporation of alcohol).

Differential diagnosis

Differential diagnosis ■ CHMT. The difficulty lies in the fact that the likelihood of CMT in a person in a state of deep alcohol intoxication is extremely large. Even when falling in a flat place due to the lack of coordination, such persons receive heavy damage Heads. Diagnostics helps the information received from the surrounding (it is important to compare a possible amount of drunk with the severity of the coma: the inconsistency can talk about CHMT), detecting damage to soft tissues of the head, anisocoria. ■ Stroke (acute violation of cerebral circulation) can develop independently or be provoked by alcohol use (especially hemorrhagic stroke). The diagnosis is based on the identification of focal neurological symptoms (see the article "Stroke"). ■ poisoning with alcohol surrogates, drugs, sleeping pills, tranquilizers or other substances, like ethanol, is able to call anyone (see below and the article "Coma", "medicinal poisoning"). ■ Options for comatose conditions for diabetes, diabetic (ketonemic), hyperosmolar and hypoglycemic coma (see Articles "Coma Diabetic (Diabetic Ketoacidosis)", "Coma Hyperosmolar"). ■ Alcoholic ketoacidosis, which in turn has to differentiate with a diabetic room. It develops in 24-72 hours after the abolition of alcohol at the end of heavy bobby. The patient complains of nausea, vomiting, abdominal pain, refuses food. Hypovolemia is rapidly growing. A confusion of consciousness appears, coma develops. Tahipne is noted and even breathing Kussmouuly as an answer to ketoacidosis. Characteristic laboratory signs: Normal or reduced blood glucose level, ketonemia and ketonuria (due to a peculiar set of ketones before the start of treatment - the predominance of β-hydroxybutyrate - the reaction to ketones when the indicator strips can be mild, despite the abundance of ketones in the urine). Trucks are treated with complete restoration of the BCC due to infusion of dextrose without insulin and salt solutions. Electrolite control is required, as hypokalemia is possible. Additionally assign thyamine. It must be borne in mind that in the process of improving the condition of the patient, the reaction to ketones in the urine will become more and more pronounced (as a result of oxidation of β-hydroxybutirate in acetoacetate) - should not be regarded as a sign of aggravation of pathology.

Indications for hospitalization

Treatment of indications for hospitalization is hospitalized persons with severe intoxication by alcohol, accompanied by a comatose state, respiratory impairment and blood circulation. The victims are delivered to the intensive care unit or toxicological center.

Medical events

Therapeutic measures ■ Since the use of analeptic drugs in ethanol poisoning is contraindicated (due to the danger of development convulsive syndrome; There are only insufficiently confirmed clinical data on possible application Fluumazenil - 3 mg intravenously), in all cases, accompanied by sharply pronounced disorders of breathing and blood circulation, it is necessary to resort to resuscitation benefits. The situation is very likely to stop breathing in continuing cardiac activity. Offensive clinical death requires the entire complex cardiovascular resuscitation. ■ The implementation of the basic resuscitation benefit will greatly facilitate the presence of electromechanical or mechanical suction, since the victim is usually observed with abundant savance and bronchory, if it did not have time to develop dehydration.

■ Washing the stomach through the probe is necessary, but perhaps only after ensuring full protection respiratory tract The intubation, which is carried out by a resuscator in place or in the hospital. In this regard, all activities of the first stage of assistance should be carried out very quickly.

Drug therapy

Drug therapy ■ At the stage of providing the first qualified medical care, you can proceed to the implementation of forced diurea. For this through venous access The infusion therapy begin and entered Furosemid (see the article "Poison, General Aspects"). ■ Supporting therapy with ethanol poisoning includes the use of soluble dextrose solutions (if the victim does not suffer from diabetes mellitus) to prevent hypoglycemia and ketoacidosis. ■ Showing also parenteral drugs Potassium, magnesium, thiamine, pyridoxine, ascorbic acid, etc. ■ As an auxiliary measure, it may be necessary to use atropine (1 ml of 0.1% solution subcutaneously) to reduce hypersolation and bronchio breve. ■ Hard hemodynamic disorders accompanied by arterial hypotension require other than the introduction of an additional amount of liquid, the use of catecholamines (see articles on shock) and, possibly prednisone at a dose of 90-120 mg intravenously.

Possible complications

Possible complications ■ periods of psychomotor excitation with short episodes of auditory and visual hallucinations (during the exit of the alcohol coma). ■ Aspiration of the contents of the stomach with the development of the atelectasis and the detailed picture of the Mendelssohn syndrome (asthma-like state and edema, arising in 2-5 hours after aspiration).

Forecast The prognosis depends not so much from the dose of alcohol, as from the timeliness of the assistance rendered (98-99% of death occurs at the prehospital stage). In chronic alcoholics, whose poisoning occurs against the background of encephalopathy, hormonal shifts, cardiomyopathy, kidney lesions, liver, lungs, hypomantee, hypovitaminosis, it is logical to expect a more severe clinical picture and the worst prediction.

The poisoning of alcohol surrogates is the type of intoxication due to the intake of low-quality alcoholic beverages containing technical compounds or poisonous impurities. It often occurs in people who suffer from dependence or adolescents who want to be injured and at the same time buy a product at a low price. Accompanied by disorders of the digestive, nervous, cardiovascular system. There is a high probability of fatal outcome, therefore requires emergency care and urgent hospitalization into the separation of toxicology. It has its own code on the ICD 10 - T51.

What belongs to alcohol surrogats?

According to the classification, they are divided into two groups: True and false. The first includes alcoholic beverages that contain ethanol, but also toxic impurities: ethers, heavy metals, harmful dyes. The second form includes the products based on any other alcohol: methyl, isopropyl and others. Poisoning in this case proceeds much harder, since not only metabolites are considered to be poisonous, but also the main connection.

Surrogate substitutes usually drink people suffering from alcoholism, and adolescents who do not have the means to purchase high-quality, but expensive products. The following compounds are considered to be the reasons for intoxication:

Toxins lead to cancer, blood diseases and blood vessels, heart disease and many others, up to conventional chronic and cold illness.

• denatures;
• polish;
• wood veil;
• medicinal medicines (tincture);
• cosmetics;
• household accessories in the form of solutions, aerosols;
• moonshine.

There are still poisoning due to the separation of brake fluid, anti-icers and other similar substances.

Clinical picture with intoxication

Signs of the disease are different, vary depending on what has accepted the patient. Below are described in detail the manifestations of pathology when painting a certain chemical component.

Surrogates containing ethyl alcohol

The first thing that feels the victim is: Euphoria and emotional arousal, which is achieved during the gatherings. Next, the clinic is complemented next symptoms:

• excessive sweating;
• increased saliva production in purph cavity;
• pallor skin;
• an increase in the diameter of pupils;
• dizziness;
• violation of coordination of movements;
• nausea;
• vomiting;
• diarrhea;
• pain in the abdomen.

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Perhaps a change in consciousness, the appearance of delusional disorders, hallucinations.

Methanol (wood alcohol)

They differ in greater toxicity, the deadly outcome is possible when using fifty milliliters of surrogate, however, it all depends on the sensitivity of the body of the victim. Signs of poisoning are as follows:

• depressive syndrome;
• nausea;
• vomiting;
• reducing acuity of vision up to its full loss;
• an increase in body temperature;
• convulsions;
• weakness;
• violation of consciousness, its absence.

Often bother disorders from the cardiovascular system, namely tachycardia, arterial hypotension, sore pain.

Symptoms of ethylene glycol poisoning

The clinic is divided into three periods. At first, the patient does not impose any complaints, only light euphoria feels. Next, after 10-12 hours such signs are formed as:

• unbearable thirst;
• nausea;
• dryness mucous membranes;
• headaches;
• cyanosis;
• vomiting without bringing relief;
• convulsive syndrome.

If you do not take proper measures, renal, hepatic or heart failure is formed on the second or third day. The skin acquires a yellow shade, the volume of the separated urine is reduced. Man dies in flour.

Diagnosis of intoxication

Must be organized immediately.

The doctor initially collects anamnesis of the disease, life, conducts a general inspection, pays particular attention to the smell of the mouth, the consciousness of the victim, the skin. After, laboratory and tool methods Surveys. The most informative is considered:

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• general urine analysis;
• general I. biochemical analysis blood;
• electrocardiogram;
• Ultrasound abdominal cavityhearts;
• CT and MRI;
• electroencephalogram.

ECG is usually carried out by Dr. SMP, which allows you to identify disorders that threaten the patient's life, and to stop them on time.

First aid

Conducting manipulations in the early stages of poisoning by alcohol surrogates will avoid the formation of complications and fatal outcome. The action algorithm includes the following items:

• washing the stomach with soda solution and by pressing the root of the tongue;
• reception of the sorbent;
• the use of saline laxative;
• call a doctor with an emergency hospitalization.

During the procedures, it is forbidden to give additional medicinal productsmay deteriorate the course of poisoning.

Antidote

It all depends on what kind of surrogate received a person. If the intoxication is caused by a true type, the state is stopped using Pirazole derivatives. In cases where the disease was formed due to methyl alcohol, ethanol injected intravenously.

Treatment methods

Therapy is appointed narcologist after a full survey. The main purpose of receiving medicines is the detoxification of the body, a decrease clinical manifestations and reducing the risk of developing complications.

In most cases, the following groups of drugs are issued:

• saline solutions;
• diuretics;
• nootropics;
• neuroleptics;
• vitamins;
• sorbents;
• antacids;
• analgesics;
• spasmolytics.

The treatment is sometimes complemented by glucocorticoids, beta-adrenoblockers, atropine. Possible mechanical blood purification with hemodialysis, plasma. The patient's rehabilitation takes place at home for one month.

Possible consequences

According to statistics, with timely diagnosis and adequate therapy, the forecast is favorable. Otherwise, such complications are developing as:

Surrious data!

in 93% of all diseases in the world are to blame ... Toxins!

• blindness;
• brain swelling;
• renal, liver failure;
• mental disorders;
• acute alcohol hepatitis;
• pancreatitis;
• hypovolemic shock;
• acidosis.

The most terrible consequence of surrogate poisoning is considered lethal outcome.

Prevention

• acquire products in specialized proven stores;
• comply with storage and transportation conditions;
• reduce the volume of alcoholic beverages.

If you buy alcohol - do not skimp. Champagne for 150 rubles or brandy for 300 is most likely made not from the best raw materials and not in the best conditions.

Summary

Such pathologies, unfortunately, in medical practice are constantly found, their frequency is growing every year. If earlier everything was written off on the illiteracy of the population, low financial income, now the poisoning even "elite" alcoholic beverages is not excluded. That is why doctors recommend not to drink at all, and if we use alcohol, then only high-quality and purchased in proven points.

doctor-Medic.ru.

Incication of alcohol surrogates

The poisoning of alcohol surrogates ranks first among all intoxication with which victims are addressed to medical institutions. This is a very dangerous phenomenon that can not only provoke severe complications, but also lead to a deadly outcome. Alcohol Surrogate Poison - Code of ICD 10:

• T51.0 - ethyl alcohol;
• T51.1 - methyl alcohol;
• T51.2 - Isopropyl alcohol;
• T51.3 - Suggest oils;
• T51.8 - Other alcohols;
• T51.9 - unspecified alcohol.

Classification of Surrogatov

The toxicology of alcohol poisoning and its surrogates allocates two types of substances: those that are produced on the basis of ethanol and made using impurities. The next group has the following:

1. ethanol made using hydrolysis of wood;
2. denatured alcohol;
3. cosmetic lotions, cologne;
4. bF glue - the composition includes polyvinyl acetal, phenol-formaldehyde resin dissolved in acetone, alcohol;
5. politura - a mixture of ethanol with butyl, amyl, acetone;
6. nigrosin is a veil containing ethanol, dyes. It is used for wood processing, skin painting in blue color.

The second variety includes chemicals that do not contain ethanol. They are made using ethylene glycol, methyl alcohol with the addition of various impurities.

Symptomatics

Symptoms of poisoning with various alcohol surrogates differ from each other. If any signs of intoxication occur in a dangerous substitute for alcoholic beverages, it is necessary to immediately contact medical institution For professional help. Otherwise, everything can end in deplorable.

Surrogat with ethanol

Ethyl alcohol is a substance that is contained in any alcoholic beverage. Ethanol poisoning is accompanied by the following symptoms from:

• GTC: threading in the stomach, feeling of nausea, vomit, violation of the chair;
• CNS: strong excitability, feeling of euphoria, expansion of pupils, auditory and visual hallucinations, incoherent speech (reminiscent of the speech), loss of coordination of movements, increased sweating;
• cardiovascular system: weakness, red or pallor skin on face, rapid pulsation, reduced intravenous pressure;
• respiratory organs: acute respiratory failure, shortness of breath;
• kidneys: frequent urination, or its stop;
• liver: The pain on the right side in the ribs, the yellowness of the skin.

Strong poisoning by surrogates can cause a comatose state.

Ethyl alcohol, after penetration into the body, absorbed into the walls of the gastrointestinal tract. With a flow of blood fluid, it quickly spreads throughout the body. With small doses of ethanol, the liver is able to cope with its processing. If the ethyl alcohol was used in large quantities, the body ceases to perform its functions and the poisoning of alcohol with dangerous surrogates occurs.

Methanol.

The kidney, CNS suffer the strongest of methyl alcohol. It has a psychotropic, neurotoxic effect. Arise the following signs Inxication with surrogate alcohol:

• feeling of nausea, vomit urge;
• "Points" before your eyes;
• before your eyes;
• in acute situations - full blindness;
• expansion of pupils;
• lack of reaction to light.

After a couple of days, the clinical picture worsens. There is a pain syndrome in the whole body. There is dry mucous membranes, leather. The functionality of the cordial organ is broken, intravenous pressure is lowered. The temperature is greatly improved. Cautions may appear, coma.

Ethylene glycol

This substance enters into components of brake fluids, antifreeze. With intoxication, an acute lack of liver, brain swelling occurs. The following toxicological symptoms are observed:

• in the first 12 hours, only not strong intoxication is observed;
• after that, nausea begins, vomiting, migraine, stool violation;
• skin sinusiness, mucous membranes;
• high body temperature;
• violation of the rhythm of the heart;
• strong excitability;
• difficulty breathing;
• loss of feelings;
• convulsions;
• dark color urin.

If not available need care When poisoning alcohol surrogates, death will come.

Moonshine

When inxicating, the moonshine arises the following signs:

• feeling of nausea, vomiting call, stool disorders;
• dizziness, right up to loss of consciousness;
• increased temperature bodies;
• severe thirst, dry mouth;
• labored breathing;
• intravenous pressure jumps;
• chills, high sweating.

In severe cases, cramps may occur. The victim loses sight. First, visual and auditory hallucinations arise. After that, a person can go to whom.

Diagnostic research

Before appointing adequate treatment, a specialist produces a complete survey of the victim. First of all, he conducts a visual inspection. After that, the history of pathology collects: the stage of alcoholism, used substances, the presence of concomitant diseases and so on.

Also prescribed additional methods diagnostics. It is necessary to study the rhythm of the heart, the amount of toxic element in the blood. Studies are complicated by the fact that the most often falling into the clinic already in a coma. But modern medicine does not stand still, with proper first aid and modern hospitalization of the patient, you can save.

Emergency measures

In a timely manner, the first help is able to save life to a person. Therefore, it is necessary not to be confused in an emergency and do everything right. First of all, call the brigade of medical workers, and then proceed to action:

1. Provide air intake victim. To do this, open all windows and windows. If possible, take a patient on fresh air. Unbutton collar, remove the tie, belt, corset.
2. Put the victim on the horizontal surface on the side. Pull the bottom hand forward. Control so that the poisoning does not illuminate the fluid, not suppressed by his own language.
3. If the patient is in consciousness, he needs to make a rings of the gastrointestinal tract. To do this, give the poisoned drink a rich amount of fluid. After that, provoke a vomit reflex, pressing your fingers or spoon at the beginning of the tongue. Action repeat until the leaving fluid becomes transparent. It is well washed with a stomach of water-salt, weakly pink manganese solutions.
4. If the victim is without feelings, bring the cotton disk, moistened in the ammonia alcohol without feelings. Also come to help the rubbing of the uches, the tip of the tip of the nose.
5. After the release of vomit masses is broken water salt balance. To bring it back to normal, it is necessary to give the patient sorbents. For example, activated carbon.
6. If the patient was poisoned as a result of the admission of ethylene glycol or methyl alcohol, let me drink a little vodka or other high-quality alcoholic beverage.
7. If the victim is frowning, we look at it with a blanket.

When stopping heartbeat and respiration, it is necessary to produce an indirect massage of the heart body and commit artificial ventilation lungs.

What you can not do

With a pathological condition, it is forbidden to make the following:

• turn over man with belly to the top;
• place the victim under the cold shower or in the bathroom;
• make a patient to show physical activity;
• provoke vomiting if the poisoned is in an insensitive state;
• give any medicines, with the exception of sorbents;
• leave a person one, unattended;
• refuse hospitalization in the hospital, even if the victim has become better.

If this is not taken into account, you can harm the patient.

Therapy

Therapeutic measures are carried out in stationary conditions, in the ward of intensive therapy in the separation of toxicology. The treatment of acute poisoning by alcohol surrogates should be produced under the clock observation of medical workers.

1. The hospital produces detoxification of the body using a special probe. The alcohol is introduced 5%. Dorganic drugs are prescribed, blood fluid is cleared.
2. When inxicating, the ethylene glycol is assigned calcium gluconate. Use a solution of glucose with novocaine, vitamin complexes B and C. When poisoning with methyl alcohol, spinal points are made.
3. After cleansing the body, a special diet must be observed. Food should be light and balanced. There is a complete refusal of alcohol products, even good quality.

Effects

Alcohol addiction is a severe disease that must be treated in mandatory. Otherwise, regular intoxication of alcohol and its surrogates can lead to severe consequences, up to death:

• hepatitis of acute character;
• pancreatitis;
• cirrhosis of the liver;
• liver failure;
• the emergence of thoughts about suicide;
• vascular vegetative violations;
• loss of vision;
• tremera hands and other heavy pathologies.

If you cannot get rid of alcoholism yourself, contact a narcological clinic for help. They not only clean the body, but also help to cope with the psychological dependence.

In addition, all drinks, including made at home, can be other alcohols: methanol, isobutanol, isobutylcarbinol, etc. All of them are the main components of the seawous oil. Excessive concentration of this by-product of alcohol fermentation can cause strong poisoning.

Ethanol.

At the concentration of alcohol in the blood of 0.4% coma comes. Concentration more than 0.6% can lead to a heart stop.

For ethanol poisoning, a breathing disorder is characterized due to the aspiration of the mucus and the spares of the language. The development of acute renal failure is possible.

If after taking ethyl alcohol, there is no loss of consciousness, the doctors regard it as an alcoholic intoxication that does not require emergency care. From such a state, a person comes out independently. For removal light symptoms The hangover uses publicly available medicines from headaches.

Methanol.

Methyl, or wood alcohol is inferior to ethanol on the drug effect. By toxicity, it is weighty superior to ethyl alcohol, because it decomposes into formaldehyde and formic acid. The central nervous system is seriously affected by these poisonous substances. Arterial pressure When taking methanol rises, and after sharply falls.

Inxication is fully manifested when adopting no more than 300 ml of methyl alcohol. The person drops reflexes, breathing is disturbed, vomiting appears and involuntary urination is observed. We begin with vision problems that can lead to blindness.

Female outcome with methanol poisoning comes from respiratory disruption.

Propanol

Isopropyl (propyl) alcohol can enter the body inhalation, orally and through the skin.

Selection of propanol and acetone (metabolite of propyl alcohol) with exhaled air begins 15 minutes after the reception. The process of liberating the body from these substances is happening with urine. The selection of acetone can last a few days.

Propyl alcohol provokes headache, dizziness, light-friendly, heartbeat violation. Perhaps impairment of sight and hearing. In the case of severe poisoning, coma comes, and later the death caused by stopping the breath.

Syuvous oils

Syvoye oil is a mixture of higher monohydric aliphatic alcohols, ethers and other compounds. It is present in almost all alcoholic beverages, but only individual monohydric alcohols have toxicological significance: isoamyl, isopropyl and isobutyl.

Danger of Surrogatov

Alcohol substitutes based on components from a group of monatomic, polyhydric alcohols, organic solvents drugs affect the central nervous system. In terms of its action, they are similar to ethanol, but more toxic.

Surrogates are used in everyday life and in production for technical purposes. They are not originally designed to receive inside.

Surrogates include moonshine - the product of the handicap distillation of Braga.

FROM high concentration Singo-name alcohols is characterized by a rapid violation of consciousness, a deep lesion of the central nervous system and a heavy percase syndrome.

The frequent reception of surrogates provokes the development of psychoorganic syndrome. It is characterized by a deterioration in memory and the drop in the level of thinking.

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Alcoholic surrogate against excise: who is who?

What drinks is more harmful?

In order to determine which type of alcohol will bring the greatest harm, you need to know the dose of ethanol, which is planned to be taken, the degree of cleaning of the drink, as well as the possible additives that give color or fragrance.

To get enough high degree Inxication It is recommended to stop your choice on concentrated drinks: vodka or brandy. If I want to drink a little, then it is better to give preference to low-graduate alcohol - beer or guilt.

If I want to drink a little, then it is better to give preference to low-graduate alcohol - beer or guilt.

It is undesirable to use liquors, since with their manufacture often the cheapest alcohol is often used.

For whom is more dangerous?

Despite the fact that beer applies to low-alcohol drinks, doctors do not recommend drinking it daily. And men and women, it can harm the large number of phytoestrogen - female hormones of plant origin.

Many in themselves danger and alcoholic cocktails, especially for women and adolescents. In addition to alcohol, in these beverages there are fruit juices, dyes, sugar, essential oils and spices. Such a totality of components causes damage to the liver and pancreas.

Unacceptable drinking alcohol during pregnancy and breastfeeding. With perinatal intake of alcohol, such a phenomenon may occur as donormorphia - alcohol fetal syndrome. These are congenital anomalies and chromosomal disorders.

If pregnancy at the planning stage, then for 4 months before conception from alcohol, a man should be abandoned. Otherwise, intrauterine malformations may occur.

When alcohol uses a nursing woman, then the child is possible a violation heart Rhythm, the emergence of strong intestinal colic, mental delay and physical development.

Drinking women are often observed gynecological diseases, including breach of menstruation.

Against the background of abuse alcoholic beverages and women and men develop chronic diseases Skin: Eczema, neurodermatitis, psoriasis. The weakening of immunity caused by alcohol entails Rosacea and herpes.

Many in themselves danger and alcoholic cocktails, especially for women and adolescents. In addition to alcohol, in these beverages there are fruit juices, dyes, sugar, essential oils and spices.