Use of alcohol-containing liquids - frequent cause acute poisoning alcohol surrogates in adults. With a similar problem face mainly people suffering. By itself, it is moderate, easily penetrates the fabric and in a large dosage leads to the defeat of many organs (liver, brain, stomach, hearts, vessels). The poisoning of alcohol surrogates is more dangerous, as they contain various harmful impurities. Strong poisoning can cause fatal outcome. Code of ICD-10 T51.

The use of alcohol-containing liquids is a frequent cause of sharp poisoning in adults.

What refers to surrogates

Surrogates are called liquids containing alcohol, but not intended for use inwards in order to obtain euphoria. They can be used in technical and medical purposes. Surrogates are true (contain ethanol) and false (contain other alcohols). These include:

• varnish;
• medicines used in heart disease (hawthorn tincture);
• technical alcohol;
• moonshine;
• antifreeze;
• brake fluid;
• tools for cleaning glass;
• lotions and colognes;
• morida;
• "Painting" vodka;
• white Spirit;
• methyl and butyl alcohols;
• ethylene glycol.

Homemade drinks

Many women and men use alcohol solutions Homemade cooking. These include moonshine fluid. It is obtained using a special apparatus by distillation of Braga. During this process, many volatile compounds are formed, including methyl alcohol. With incorrect distillation (cleaning of the solution from impurities), it is possible to preserve toxic substances. Homemade alcoholic beverages are in solid demand in rural areas. Such people often observed poisoning of alcohol surrogates.

Alcoholic poisoning

Alcoholic poisoning

Medications containing alcohol

In order to achieve the state of intoxicating alcoholics can use alcohol-based drugs. Most in demand:

• hawthorn tincture;
• tincture of valeries;
• motherwort tincture.

Hawthorn tincture can be purchased in any pharmacy affordable price. This medicine contains alcohol and fruit, is used for diseases of the heart and nervous system. The hawthorn improves blood flow and have a soothing effect. When using in high doses, the work of the heart is disturbed and pressure drops. People who use this medicine often develop heart failure.

How to determine

Surrogates can be distinguished from alcohol products intended for mass use, in the smell, color and method of use. All household products (solvents, technical alcohol) can not be used inside.

Today, among all cases of intoxication, with a subsequent severe or even fatal outcome, the poisoning of alcohol surrogates occupy 50%. At the same time, the unenviable fate overtakes not only avid alcoholics, but also quite decent people who are in moderation. The cause of such cases is the unfair production of alcoholic beverages with a gross violation of the technology of their manufacture or deviation from the formulation.

Important: acute alcohol poisoning and its surrogates in 98% of cases leads to the death of the patient before its hospitalization. In other cases, the saved man remains disabled.

Surrogate alcohol: definition

In response to the question "What such surrogate alcohol" should be conveyed to the reader information that those who were produced by a handicraft violation of the formulation or those that have ended with storage / implementation are considered to be the reader. Such alcohol is so toxic for the human body, which in the ICD 10 (international classification of disease) such states have their code. In particular, precisely the poisoning of this type is designated by the encoding in the range T51.1-T52.9. And on the ICD-10 defined codes, each component is classified, which is the main active substance in a surrogate drink.

All low-quality (surrogate) alcoholic beverages can be divided into two main groups:

• Alcohol with an ethyl alcohol content and its derivatives. These include beverages based on butyl alcohol (mortality for an hour when taking 30 ml), sulfite and hydrolyste alcohol, technical alcohol or denaturate. Also, this category includes all lotions / colognes / politics and veil. In the latter case (with the use of vehicles), skin cover and mucosa of the patient acquire blue color.
• False surrogate. This is the most dangerous man's life category of low-quality alcoholic beverages. To reduce the cost of alcohol production, instead of ethanol methyl alcohol or ethylene glycol. Both lead to paralysis or human death.

Clinical Picture of Alcoholic Surrogate Poisoning

It is worth understanding that, in poisoning by the surrogates of alcohol, symptoms may have a different picture depending on the initial alcohol included in the drink. So consider everything in detail.

Symptoms of ethylene glycol beverages poisoning

The kidney and the liver of a person suffer from the use of such alcohol. With the late provision of medical care, the failure of these bodies is formed. In especially serious cases, the patient suffers from the CNS. But it should be known that the poisoning of ethylene glycol can divide the symptoms for the periods:

• Early period. It is characterized by standard signs of intoxication of a person, but it lasts 12 hours while maintaining a picture of an oxane man. The health of the patient remains normal.
• Defeat CNS. After a period marked, the duration of 12 hours at the poisoning appear shows signs of lesion of the central nervous system. It is noted the skin of the skin and mucosa. There is nausea and vomit reflexes. Mixed diarrhea. Against the background of this, the patient marks an increase in body temperature and a significant expansion of pupils. Problems begin with a respiratory center (shortness of breath, heart impairment). In the worst case, the patient loses consciousness with subsequent convulsions.
• Loosening liver and kidneys. This period takes 2-5 weeks from the reception of the first dose of surrogate drink. There are all the symptoms of renal and liver failure. There is no absence or reduction of diuresis, yellowing of the skin, strong itching.

Methyl alcohol poisoning symptoms

These drinks with methanol are affected by the body, hitting the kidneys and CNS. In particular, the psyche suffers, vision. Methanol mortal dose for a healthy person is only 50-70 ml. It should be known that alcohol surrogates with methyl alcohol are very quickly absorbed into the blood of the stomach and the small intestine.

Signs of methanol poisoning are:

• Dyspeptic disorders (nausea, vomit reflex, diarrhea);
• Vision disorders (black flammable goosebumps before eyes, periodic blindness or twin pictures);
• Lack of reaction to light stimuli and expansion of pupils;
• Spasmodic abdominal pain, lubrication in the body and muscles, manifested in 1-2 days after the adopted dose of methanol;
• Increase temperature to 38 degrees;
• Fall hell;
• Dryness and itching of skin;
• Failures in the work of the heart muscle;
• Periodic excitation attacks that are replaced by apathy attacks.

If you don't have a sick help on time, then at the increasing symptoms of the patient, you can go to whom with the subsequent paralysis of the hands and legs.

Important: In case of ethylene glycol or methyl alcohol, the forecast for a person is less favorable than in poisoning by surrogates from the above-mentioned first group.

Clinical picture of poisoning by surrogates from the first group (ethyl alcohol)

In this case, the primary signs of alcohol poisoning will be standard symptoms of intoxication. Then later in the patient will develop such signs:

• Strong excitation of both motor and emotional;
• Hyperemia of the face of the face;
• Increase sweating and salivation;
• Flashing to Euphoria.

Later develops a number of such signs:

• Early urination;
• Leather pale;
• Dry mouth;
• Expansion of pupils;
• Reducing coordination of movements;
• Incoherent consciousness.

Proponial assistance in surrogate poisoning

It is worthwing to know that when suspected of poisoning with surrogates or with obvious poisoning, surrogate alcohol should immediately call ambulance. Even if an externally person is in more or less normal condition and conscious. The toxic impact of surrogates is fleeting and the picture may change literally for several tens of minutes (depending on the adopted dose). In the meantime, a person is conscious, a number of measures should be taken, which will prevent severe alcohol poisoning. Namely, first aid looks like this:

• Clear the stomach from toxins, causing vomiting. Drink water or manganese pink solution and tear up until the vomit will take the type of pure water.
• Provoke a climb chairs. For this drink salted solution. On 1 liter of water a teaspoon salt.

If the patient lost consciousness, then you need to do the following before the arrival of the doctors:

• Release the chest and throat from squeezing clothes.
• Provide the influx of fresh air to the room.
• Put the patient on the side to avoid chilling by the lot.
• Clean the oral cavity from the vomit, if any.
• Make artificial respiration when stopped.
• Try to bring the patient to the feeling method of ammonia or the rubbing of the oars.

Important: If the patient is conscious and at the same time there is a suspicion of methanol poisoning, then it is worth knowing that ethanol in this case is an excellent antidote. That is, poisoning with methyl alcohol, you need to give a glass of good vodka. It neutralizes methyl toxins. All the same should be done in relation to yourself if you poisoned.

Treatment of poisoning in the hospital and the consequences of poisoning

The effectiveness of treatment and the general forecast for the victim will be fully dependent on the adopted dose of surrogate and the timeliness of medical care. In addition, an important factor is the initial physical condition of the patient. Thus, chronic alcoholics are harder to carry the toxic impact of surrogates. However, the consequences for those and for others may be the same - from loss of vision and paralysis to death due to kidney or liver failure.

In general, a number of certain events apply in the hospital in relation to the victim. Emergency care in poisoning looks like this:

• Protecting stomach. It is shown in the event that the victim is conscious.
• Reception of sorbents for the purpose of binding and removing toxins.
• Introduction intravenously antidotes. In most cases, ethanol is used. In the case of poisoning ethylene glycol, calcium gluconate is used as an antidote.
• Strengthening diuresis for emergency toxins through the kidney (shown only during the normal functioning of the kidneys).
• Introduction to the body of vitamins of the group B, C. Relaxing, a person loses all the electrolytes, minerals and vitamins, which requires restoring their balance.

Important: In the case of poisoning with methyl alcohol, puncture performs spinal cordwhich are the method of reducing the cranial pressure.

Tip: For the purpose of saving life and health, refuse to use surrogate alcoholic beverages. Remember, health does not need to drink a glass of alcohol, and the poisoning by surrogates entails trouble.

Acute alcohol poisoning (ethanol) is usually associated with the admission of ethyl alcohol or beverages containing more than 12% of ethyl alcohol. The deadly concentration of ethanol in the blood - 5-8 g / l, deadly motherwise dose - 4-12 g / kg (300-500 ml of 96% ethanol); However, this figure is spilled in different patients and often depends on the acquired alcohol tolerance. Acute alcohol poisoning is most widely distributed in the countries of the northern and medium latitudes.

Code for the international classification of diseases of the ICD-10:

• T51.0.

Frequency. 25% of all acute poisoning. More than 60% of all fatal poisoning is caused by alcohol. The prevailing floor is male.
Risk factors . Alcoholism (about 90% of alcohol hospitalized with acute alcohol poisoning is sick alcoholism). Use of alcoholic beverages on an empty stomach (the dietary masses in the stomach slow down the absorption of alcohol). Alcoholic beverages Fortress up to 30% are absorbed faster.

The reasons

Pathogenesis . Ethanol easily penetrates through the tissue membranes, quickly absorbed in the stomach (20%) and the small intestine (80%); On average, after 1.5 hours, its blood concentration reaches the maximum level. Ethanol has a psychotropic (narcotic) effect, accompanied by the suppression of the excitation processes in the CNS, which is due to the change in neuron metabolism, disruption of the function of mediator systems, a decrease in oxygen disposal. The development of metabolic acidosis (the accumulation of acidic products of its biotransformation).

Symptoms (signs)

Clinical picture
. General features .. Emotional lability .. Violation of coordination of movements .. Redness of the face .. Nausea and vomiting .. inhibition of breathing .. impairment of consciousness.
. Alcoholic coma develops at the concentration of ethanol in the blood of 0.3-0.7 mg%. The symptoms of the alcohol coma (especially deep) is nonspecific and is an option of a narcotic coma .. Surface Coma: Lack of speech contact, loss of consciousness, reducing corneal, pupil reflexes, sharp depression of pain sensitivity. Neurological symptoms - a decrease or increase in muscle tone and tendon reflexes (often arise a bubble muscles, meningheal symptoms, myofibrillations are usually in the area chest and neck); Pathological eye symptoms (floating movements eye apples, anisocorium) are not permanent, pupils are usually narrowed (myiosis), while the increases of respiratory disorders expand. 2 periods of the surface alcohol coma are usually isolated ... 1 period: an injection or pressure in the painful nerve pain points, inhalation of the vapor of ammonia alcohol is accompanied by an expansion of pupils, a faithful reaction, protective movements of the hands ... 2 period: In response, only weak occurs in such irritation. Hyperthonus of hands and legs, myofibrillation; picky reaction It is not constant .. deep coma: complete loss of pain sensitivity, no or sharp decline in corneal, pupil, tendon reflexes, muscle atony, decreased body temperature.
. Disorders of external respiration - the main cause of death on chipboard In the absence of medical care .. Obstructivational - aspiration violations (sparkling of language, hypersivation and bronchory, aspiration of vomit), stridor, tachypan, acrocyanosis, swelling of the cervical veins, there are large-tested wheezes in the lungs, expanding pupils .. Breathing violation on the central type only arises With deep alcoholic coma.
. Violations of the Functions of the CSS .. Tachycardia is the most permanent clinical symptom .. with deep coma hell decreases sharply .. Hypercoagulation with acidosis and general hypothermia lead to microcirculation disorders.

Diagnostics

Research methods . EEG. ECG (decrease in the S-T segment, negative Tver T, extrasystolia; with alcohol cardiomyopathy, persistent rhythm and conductivity disorders are possible). Microfind test and gas-liquid chromatography - tests for the presence of ethanol in the blood.
Differential diagnosis . CMT. Acute violation of cerebral circulation. Poisoning with false alcohol surrogates (chlorinated hydrocarbons, methanol, ethylene glycol). Poisoning with sleeping drugs, drugs and tranquilizers. Hypoglycemic coma.

Treatment

TREATMENT
Tactics of keeping (see also poisoning, general provisions). Hospitalization with severe alcohol intoxication (coma, respiratory disorders and blood circulation) in the toxicological center. Ensuring adequate ventilation of lungs .. toilet oral cavity, fixation of the tongue with a linker .. In the surface coma, the air duct is introduced, the intubation is shown with the subsequent suction of the mucus and the vomit from the upper respiratory tract .. when the breathing is violated on the central type - IVL after intubation of the trachea . Washing the stomach through the probe is carried out after ensuring adequate ventilation of the lungs. Intensive supporting therapy; Events aimed at preventing hypoglycemia and ketoacidosis. Forced diuresis. Hemodialysis (by testimony). With pronounced common - aspiration syndrome - emergency sanitary bronchoscopy; To resolve the atelectasis - postural drainage. Treatment of complications. The absence of the positive dynamics of the patient's condition for 3 hours on the background of the therapy is indicated by unrecognized complications (CHMT, altectases of lungs, etc.) or an erroneous diagnosis.

Drug therapy . Atropine 1-2 ml of 0.1% P - RA P / K to reduce hypersion and bronchio breeding. Anti-co-therapy (with heavy hemodynamic disorders) .. Plasmo substitutes (polyglyukin, hemodez, refooliglucin) in / in drip .. 5% r - r glucose, 0.9% r - s sodium chloride in / in drip .. analeptics (Introduction Bemegreed or large doses of anallets are contraindicated due to the danger of the development of convulsive syndrome and obtuctive forms of respiratory disorders) .. prednisone 60-100 mg V / in drip at a persistent arterial hypotension. For the correction of metabolic acidosis - 600-1000 ml of 4% p-RA sodium hydrocarbonate in / in drip. To accelerate the oxidation of alcohol and normalization exchange processes - glucose (40-60 ml of 40% R - RA with insulin) in / in; Tiamine, pyridoxine, nicotinic and ascorbic acids. When developing complications - antibiotics.

Complications. Periods of psychomotor excitation with short episodes of auditory and visual hallucinations (when leaving alcohol coma). Convulsive syndrome (more often in individuals suffering from alcoholic encephalopathy). Alcoholic delirium. Alcohol amavrosis. Inflammatory respiratory diseases (tracheobronchita and pneumonia). Aspiration of the contents of the stomach often leads to the development of the atelectasis of lungs or Mendelssohn syndrome. Miorosal syndrome (rarely).
Four and forecast Depend on the timeliness of the assistance rendered (98-99% of death occurs in the pre-hospital stage).
Prevention - propaganda of a healthy lifestyle, treatment of alcoholism.
Synonym. Alcoholic intoxication

MKB-10. T51.0 The toxic effect of ethanol

Application. Miorosal syndrome - General microcirculation disorders with alcohol coma are exacerbated by local disorders: squeezing the main vessels with an inconvenient position of the body of the patient in a coma (fastened limbs), positioning pressure weighing its own body into separate muscle groups. This leads to the ischemic coagulative tissue necrosis. Clinically: when the consciousness is returned, patients complain of pain, the restriction of movements, the growing edema of the affected limbs (the edema is dense, usually circular, sometimes applies to the buttock or chest); As a rule, one side of the body is affected; neuritis with a decrease in all types of sensitivity; urine dirty - brown with a large amount of myoglobin (1-2 days); toxic nephropathy; In case of late or inadequate treatment - the development of OPN.

Treatment

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

The effectiveness of treatment and the general forecast for the victim will be fully dependent on the adopted dose of surrogate and the timeliness of medical care. In addition, an important factor is the initial physical condition of the patient.

Thus, chronic alcoholics are harder to carry the toxic impact of surrogates. However, the consequences for those and for others may be the same - from loss of vision and paralysis to death due to kidney or liver failure.

In general, a number of certain events apply in the hospital in relation to the victim. Emergency care in poisoning looks like this:

• Protecting stomach. It is shown in the event that the victim is conscious.
• Reception of sorbents for the purpose of binding and removing toxins.
• Introduction intravenously antidotes. In most cases, ethanol is used. In the case of poisoning ethylene glycol, calcium gluconate is used as an antidote.
• Strengthening diuresis for emergency toxins through the kidney (shown only during the normal functioning of the kidneys).
• Introduction to the body of vitamins of the group B, C. Relaxing, a person loses all the electrolytes, minerals and vitamins, which requires restoring their balance.

At the stage of primary health care, it is recommended to normalize disturbed breathing and restore or maintain adequate hemodynamics (see 3.1 "Treatment of hemodynamic disorders".

Responsiveness level - D (level of evidence - 4)

1. in cases of aspiration-obtuctive respiratory disorders, it is recommended to carry out the toilet of the oral cavity, athropic ** (1-2 ml of 0.1% solution) are subcutaneously administered to reduce hypersion and bronchio bream
2. with surface coma, the contents of the contents of the upper respiratory tract using the air duct are carried out;
3. with deep coma - spend the trachea intubation.
4. with a breath violation in the central type, artificial ventilation of the lungs is needed after preliminary intubation of the trachea.
5. in the mixed form of disorders, the aspiration-obtuctive respiration disorders are first eliminated, and then plug in the artificial ventilation of the lungs.
6. the inhalation of oxygen is shown.
7. to resolve the atelectasis - conducting a sanational FBS.

With severe hemodynamic disorders, anti-shock therapy is recommended: plasm-substituting solutions intravenously, salt solutions and glucose solutions.

After stopping the respiratory disorder and related hypoxia, the use of succinate preparations was recommended (sodium sodium meglumin solution ** - 1.5% - 400, 0) and cardiovascular funds in therapeutic doses (Cordiamine, caffeine).

The correction of the water and electrolyte balance is recommended to be carried out with crystalloid, colloidal solutions and glucose under the control of the pulse, blood pressure (AD) and the central venous pressure (CVD), the heart index, the total peripheral resistance, hematocrit, the concentration of hemoglobin and electrolytes, and diuresis.

The overall supercooling of the body is below the critical level in persons with alcohol coma, which were outside the closed heated premises during the cold season;

Chronic alcoholic intoxication in a terminal stage with signs of polyorgan deficiency (hepatic, cardiovascular, metabolic disorders) alcohol cardiomyopathy;

Acute alcoholic delirium on the background of chronic alcohol intoxication, developing almost immediately after the patient's output from the alcohol coma, is dangerous with complications (phenonia, brain swelling, acute cardiovascular failure.

Order No. 520n of the Ministry of Health of the Russian Federation of June 15, 2016 "On approval of the criteria for assessing the quality of medical care p.3.13.6;

Toxic effects of substances, mainly non-medical destination (T51-T65) / World Health Organization // International Statistical Classification of Health Association and Problems. Tenth revision. Volume 1 (part 2) .- M.: Medicine, 1995.- P. 337-344.;

Order of the Ministry of Health of the Russian Federation No. 925n of November 30, 2012 "On approval of the procedure for providing medical care for acute chemical poisoning";

Order of the Ministry of Health of the Russian Federation of October 10, 1998 No. 298 "On the analytical diagnosis of narcotic drugs, psychotropic and other toxic substances in the human body";

Order of the MZSR of the Russian Federation of January 27, 2006 No. 40 "On the organization of conducting chemical-toxicological studies in the analytical diagnosis of the presence of alcohol, drugs, psychotropic and other toxic substances in the body of alcohol, narcotic drugs.

Chronic alcohol intoxication - poisoning of human organs with products of decay of alcohol when used in excessive doses. Alcohol dependence may not be. Unlike the long negative impact of the alcohol to the body with alcoholism, chronic intoxication causes even irregular use of alcohol if the dose of alcohol is large enough.

Treatment of maintenance (see Nonspecific drug therapy (see also poisoning, general provisions) for acidosis - 4% p - p sodium hydrocarbonate in / in to 1 000-1 500 ml / day when excited and cramps - 10 ml 25% R - RA Magnesium sulfate in / m prednisone, thiamine, trifoschadenin, ascorbic acid, glucose - plox mixture (200 ml of 40% glucose ral and 20 ml of 2% R RA products) in / in drip.

Easy intoxication does not require medical care. The patient should be given to sleep, after which its condition is normalized.

With the average and severe degree of poisoning, assistance is provided according to the following algorithm:

• status stabilization;
• stomach wash;
• detoxification of the body;
• fighting complications and symptomatic treatment.

The treatment of alcoholic intoxication at home is possible only if the victim is in consciousness, does not blue, it breathes well and does not show signs of severe toxic effect of ethanol (shortness of breath, decreased blood pressure, severe abdominal pain, low body temperature, etc.).

Stabilization of the state

The measures to stabilize the state of the patient are aimed primarily on the restoration of adequate self-breathing. To do this, with the help of electric cover from the upper respiratory tract, residues of vomit, saliva and sputum are removed.

In the absence of the necessary equipment, the procedure is carried out by winding a bandage or a napkin for two fingers and thus cleaning the oral cavity. With severe respiratory disorders in the patient's central type, the patient is intubated and translated on IVL. As a rule, this happens only with a deep alcoholic coma.

Reduce the level of hypersion can be by subcutaneous administration Atropine sulfate (0.5-1 ml). It should be remembered that the drug is able to significantly increase the frequency of heart cuts and provoke mental excitement. The latter is fixed using aminezine, haloperidol, relaignual.

Low blood pressure is corrected by appointing the injured vasopressor. With a slight decrease in hell under the skin, caffeine, Meston in a dose of 0.5 ml is introduced. Coma combined with significant hypotension is an indication for drip intravenous administration Dopamine, Noraderenlin, Mesaton.

Stomach washing

Stomach washing can be done at home or in a hospital. At home, the victim gives a drink 0.5-1 liter of water, after which they cause vomiting. The procedure is repeated several times.

For washing, clean water can be used, water with the addition of activated carbon powder or sodium hydrocarbonate (food soda). Washing the stomach in this way possible only with the saved consciousness and ability of the patient to swallowing.

In the hospital and at the SMP stage, the washing is carried out through a thick gastric probe. The latter is set in the stomach through the mouth, and after the procedure is removed.

Alcohol surrogates are liquids based on alcohols, not intended for intake. When using alcohol surrogates, poisoning is developing, which often leads to death.

Alcoholic surrogates are considered liquids with an alcohol content that are not drinks. Once in the human body, they cause intoxication with severe health effects.

Ethyl alcohol in the composition of surrogates can be both present and absent. The group with ethanol includes:

• Boutique alcohol.
• Wood alcohols.
• Denatured alcohol.
• Colognes.
• Varnish.
• Morida.

Surrogates are much toxic than alcohol. Thus, in wood alcohols, methanol is contained, in denaturate - aldehyde, a whole combination of different toxic alcohols is presented in the polysture. There are chemical dyes in the vertery, which, falling into the body, cause the skin and mucous membranes.

The second group includes "false surrogates":

• Methanol.
• Ethylene glycol.
• Isopropanol.
• Glue bf.
• Dichloroethane.

Toxic doses

Alcoholic surrogates are dangerous in that a small amount of these liquids in the body is inserted to a fatal outcome.

Their toxic doses for the development of acute poisoning differ depending on the composition:

• methanol - 7-8 ml.;
• ethylene glycol - 50 ml.;
• politura - 50 ml.;
• acetone - 30 ml.;
• isopropanol - 0.5 - 2 ml / kg;
• glue BF - 20-50 ml;
• dichloroethane - 5 ml.

Methanol in the human body is split to formic acid and formaldehyde. These substances have very high toxicity and cause serious lesions of the CNS. 7 ml. Enough for acute poisoning with fainting and loss of vision. 50 g. Cause lightning death.

Alcohol Surrogate Poisonments are very dangerous, as often accompanied by severe pathological lesions of the liver, kidney, central nervous system. Similar lesions often end with a fatal outcome of poisoning.

Part of the poisoning is associated with the use of poor-quality alcohol, but in most cases, the poisoning of alcohol surrogates is found in chronic alcoholics, which consume consumer chemicals, drug liquids and technical alcohols.

Classification of alcohol surrogates

What is alcohol surrogates? These are fluids, which contains alcohol used in everyday life and for technical needs. Use them to intoxicate when ordinary alcoholic beverages are not available. Alcohol surrogate group include low-quality / fake wine, brandy, vodka and other species alcoholic beverages.

Treatment begins with urgent washing of the stomach and the introduction of sodium sulfate through the probe. In the case of poisoning with methanol, the patient is given ethanol (antidote) orally or 2-5% alcohol solution intravenously drip.

In poisoning with substances containing ethylene glycol, a solution of sodium bicarbonate administered inside or intravenously is used to eliminate acidosis. The tactics of further treatment in poisoning with true surrogates is determined by the identified disorders from various organs and systems.

All patients conduct disintellation therapy, prescribe vitamins, nootropics, etc.

In poisoning alcohol surrogates containing methanol, prednisolone, atropine, ATP and lumbal puncture are used to correct violations of view. When poisoning ethylene glycol, the priority is becoming a struggle against kidney damage.

Patients prescribe diuretics, abundant drinking and magnesium sulfate. Correction of the water-salt balance.

In severe cases, hemodialysis or peritoneal dialysis is carried out. The forecast in poisoning by alcohol surrogates is determined by the type and amount of fluid adopted.

After using true surrogates, death rarely occurs, remote consequences are possible as a result of the defeat of the internal organs. As a result of taking substances containing methanol and ethylene glycol, a fatal outcome is often observed, many surviving patients become disabled.

Names

Alcohol poisoning.

Names

Russian title: piracetam.
English name: Piratetam.

Latin name

Piratetamum (Piratetami).

Chemical name

2-oxo-1-pyrrolidineacetamide.

Farm Group

Nootropics.

Nosology

A89. Viral infection The central nervous system is unspecified.
D57 Sick-shaped cellular disorders.
F00 Dementia in Alzheimer's disease (G30).
F01 Vascular dementia.
F03 Dementia is unspecified.
F04 Organic amnistic syndrome, not caused by alcohol or other psychoactive substances.
F05 Delium, not caused by alcohol or other psychoactive substances.
F06.7 Easy cognitive disorder.
F07.1 posturedencephaal syndrome.
F07.2 postcontezion syndrome.
F07.9 Organic personality disorder and behavior, due to the disease, damage or dysfunction of the brain, unspecified.
F09 Organic or symptomatic mental disorder is unspecified.
F10.2 alcohol dependence syndrome.
F10.3 abstinence.
F10.4 abstinence with delirium.
F10.5 psychosis alcoholic.
F11 Mental and behavioral disorders caused by the use of opioids.
F13 mental and behavioral disorders caused by sedative or sleeping pills.
F29 Inorganic psychosis is unspecified.
F32. Depressive episode.
F34.1 Distimia.
F41.2 Mixed anxious and depressive disorder.
F48.0 nestration.
F60.3 Emotionally unstable personality disorder.
F63 disorders of habits and deposits.
F79 mental backwardness is unspecified.
F80 Specific speech and language development disorders.
F90.0 Violation of activity and attention.
F91 Behavior Disorder.
G21.8 Other forms of secondary parkinsonism.
G25.3 Miklonus.
G30 Alzheimer's disease.
G40.9 Epilepsy is unspecified.
G46 vascular brain syndromes with cerebrovascular diseases.
G80 Children cerebral paralysis.
G93.4 Encephalopathy uncomfortable.
H55 Nistagm and other involuntary eye movements.
I61 intracerebral hemorrhage.
I63 brain infarction.
I67.2 cerebral atherosclerosis.
I69 The consequences of cerebrovascular diseases.
P15 Others generic injuries.
P91 Other violations of cerebral status in a newborn.
R26,8 Other and unspecified violations of gait and mobility.
R40.2 coma is unspecified.
R41.0 Orientation violation uncomfortable.
R41.3. 0 * Reduced memory.
R41.8. 0 * Disorders of intellectual-moon.
R42 Dizziness and disruptability.
R45.1 Anxiety and excitement.
R46.4 Inhibition and slow motion reaction.
R47.0 Dysfasia and aphasia.
R51 Headache.
R53 Hasive and fatigue.
R54 Old age.
S06 intracranial injury.
T40 drug poisoning and psychodisleps [hallucinogens].
T42.3 Barbiturate Poisoning.
T51 Toxic action of alcohol.
Z55 Problems associated with learning and literacy.

CAS code

Characteristic of substance

Cyclic derivative of GABC.

Pharmacodynamics

pharmachologic effect - Nootropic.
Pharmacodynamics.

Improves the links between the hemispheres of the brain and synaptic conductivity in non-Russian structures improves brain blood flow.
It has an action on the CNS in various ways: modifies neurotransmission in the brain, improves metabolic conditions that contribute to neuronal plasticity, improves microcirculation, affecting the rheological characteristics of the blood and without causing vasodilation.
Under cerebral dysfunction increases the concentration of attention and improves cognitive functions, in the PM, the ability to learn, memory, attention and consciousness, mental performance, without providing a sedative or psychostimulating impact. The use of piracetam is accompanied by significant changes in EEG (an increase in α- and β-activity, a decrease in δ activity).
It creates the restoration of cognitive abilities after various cerebral damage due to hypoxia, intoxication or electrosalproof therapy.
Shown for the treatment of cortical myoclonia both as monotherapy and in the composition complex therapy.
Reduces the duration of the vestibular neuronit and nystagma.
The hemorographic effects of piracetam are associated with its influence on red blood cells, platelets and vessel wall.
In patients with sickle-shaped anemia during the pathological rigidity of red blood cells, piracetam restores the elasticity of the erythrocyte membrane, increases their ability to deformation and filtration, reduces blood viscosity and prevents the formation of coin columns. In addition, it inhibits increased aggregation of activated platelets, without affecting their number. At a dose of 9.6 g, the level of fibrinogen and Willebrand factor is 30-40% and lengthens the bleeding time.
In animal studies, it is shown that piracetam inhibits spasm of vessels and counteracts various vasospast substances.
In research on healthy volunteers, piracetam reduced the adhesion of erythrocytes to the endothelium of the vessels and stimulated the production of prostacyclinins in the endothelium.

Definition and general information [edit]

Acute intoxication of alcohol (without consequences and the formation of the disease).

Etiology and pathogenesis [edit]

Types of alcohol intoxication

1. Simple alcoholic intoxication.

Alcoholic intoxication with hebifren features;

Alcoholic intoxication with hysterical features.

2. Pathological intoxication.

Clinical manifestations [edit]

Acute intoxication of alcohol: diagnostics [edit]

- violation of the concentration of attention;

Narrowing of mental capabilities;

Reduced mental and industrial productivity.

Negative sample of romberg;

A thorough somatoneurological examination of the patient is necessary, given the possibility of injury and infections. The patient should always be examined for possible intoxication by several substances.

Differential diagnosis [edit]

Acute alcohol intoxication: treatment [edit]

Indications for hospitalization

1. The presence of convulsive phenomena.

2. Related acute effects of CMT.

4. High temperature.

5. Physical exhaustion or dehydration.

7. severe depressive condition or obvious risk of suicidal behavior.

Therapeutic measures provide for monitoring the patient, symptomatic therapy, as necessary - parenteral nutrition.

Bibliography

Hell - blood pressure

ADG - alcoholic dehydrogenase

Alat - AlaninTransferase

Asat - Aspartattransferase

GGTP - Gamma GlutamylTranspendspendaz

GGTF - Gamma GlutamilTransferase

GD - hemodialysis

GDF - hemodailtration

GLC - gas-liquid chromatography

GCT - gastrointestinal tract

IVL - artificial lung ventilation

Kos - acid-main

CT - Computer Tomography

KFK - Creatynphosfokineza

LDH - lactate dehydrogenase

ICB10 - International Statistical Classification Classification of diseases and problems associated with the health of the tenth revision

MRI - magneto-resonance tomography

ORDS - acute respiratory distress syndrome

Orit - Department of Resuscitation and Intensive Therapy

PZ - stomach washing

Ultrasound - Ultrasonic Study

FBS - Fibrobronchoscopy

PD - forced diuresis

CVD - central venous pressure

SHF - alkaline phosphatase

EC - ethyl alcohol

EGDS - Ezophagogastroduodenoscopy

ECG - electrocardiography (cardiogram)

EEG - electroencephalography

EAPCCT - European Association of Poison Centers and Clinical Toxicologists

LD - lethal (deadly) dose

RG - radiograph

Terms and Definitions

In response to the question "What such surrogate alcohol" should be conveyed to the reader information that those who were produced by a handicraft violation of the formulation or those that have ended with storage / implementation are considered to be the reader.

Such alcohol is so toxic for the human body, which in the ICD 10 (international classification of disease) such states have their code. In particular, the poisoning of this type is indicated by the encoding in the T51 range.

Moreover, by the ICD-10, certain codes are classified each component, which is the main active substance in the surrogate drink.

All low-quality (surrogate) alcoholic beverages can be divided into two main groups:

• Alcohol with an ethyl alcohol content and its derivatives. These include beverages based on butyl alcohol (mortality for an hour when taking 30 ml), sulfite and hydrolyste alcohol, technical alcohol or denaturate. Also, this category includes all lotions / colognes / politics and veil. In the latter case (with the use of vehicles), skin cover and mucosa of the patient acquire blue color.
• False surrogate. This is the most dangerous man's life category of low-quality alcoholic beverages. To reduce the cost of alcohol production, instead of ethanol methyl alcohol or ethylene glycol. Both lead to paralysis or human death.

0 Thus, the term alcohol is actually used as a synonym for alcoholic beverages.

Alcoholic intoxication is a phrase characterizing a health disorder caused by overweight alcoholic beverages. Historically, the term "alcohol intoxication" use medical professionals of various profiles, including toxicologists, psychiatrists (mainly), judicial medicines.

Currently, the concept of "alcohol intoxication" is present in the ICD10 under the code F10 - mental and behavioral disorders caused by alcohol use, including: F.10. 0 "Acute intoxication" - like acute intoxication with alcoholism and alcoholic intoxication.

At the same time, it is customary to allocate the following clinical forms: acute alcoholic intoxication: simple alcohol intoxication; modified alcoholic intoxication; pathological intoxication; Chronic alcoholism 1, 2, 3 stages; Alcoholic psychosis (alcoholic delirium, acute alcoholic hallucinia, acute alcohol paranoid and other).

"Chronic alcoholic intoxication" characterizes the disease that has developed as a result of the long-term abuse of ES and not accompanied by a coma (with the exception of the terminal stage of polyorgan deficiency).

For this disease, various violations of behavior, psyche are more characteristic. The substitution of the concepts of "alcoholic intoxication", "acute alcoholic intoxication" and "alcohol poisoning" often leads to improper diagnosis, hospitalization and therapy of the victim.

Alcoholic coma - coma, developed by the use of ES, mainly in the form of alcoholic beverages in a toxic / lethal dose with the appearance of toxic / death concentration of ethanol in the blood.

Alcohols are an extensive and very diverse class of organic compounds: they are widespread in nature, have the most important industrial significance and have exceptional chemical properties.

Aliphatic limit alcohols with a long chain of up to 5 carbon atoms (methyl, ethyl, propyl, butyl, and amyl, and amyl) have the largest toxicological importance.

The toxic effect of alcohol (according to the formulation of the ICD10) implies health disorder caused by the use of one or more representatives of this group and treated as acute poisoning.

At the same time, from the position of the clinical characteristics of preferential importance, both in the frequency of occurrence of this pathology and for medical consequences, the presenter is the ES (ethanol) poisoning or common concept - alcohol poisoning, which is from the position of toxicologists a disorder of consciousness (to whom) caused by redundant One-step inthanol intake.

Poisoning by other alcohols of this group can manifest various symptoms With the saved consciousness.

Considering the high toxicity and specificity of clinical manifestations and complications, these recommendations are not considered toxic effect (poisoning) by methanol (methyl alcohol), which is allocated in separate clinical recommendations.

Surrogate alcohol products It is customary to be those drinks that are not originally intended for drinking. Conditionally, they can be divided into 2 groups.

First group

Short description

Acute alcohol poisoning (ethanol) is usually associated with the admission of ethyl alcohol or beverages containing more than 12% of ethyl alcohol. The deadly concentration of ethanol in the blood - 5-8 b., The deadly one-time dose - 4-12 gg (300-500 ml of 96% ethanol); However, this figure is spilled in different patients and often depends on the acquired alcohol tolerance.

Acute alcohol poisoning is most widely distributed in the countries of the northern and medium latitudes.

Frequency. 25% of all acute poisoning. More than 60% of all fatal poisoning is caused by alcohol. The prevailing floor is male. Risk factors Alcoholism (about 90% of hospitalized with acute alcohol poisoning are sick alcoholism) Use of alcoholic beverages on an empty stomach (the nutritional masses in the stomach slow down the absorption of alcohol) alcoholic beverages with a strength of up to 30% are absorbed faster.

Acute poisoning of alcohol surrogates is associated with the admission of ethyl alcohol containing impurities of various substances prepared on the basis of ethanol or other single-nominal or polyhydric alcohols.

Surrogates of alcohol prepared on the basis of ethyl alcohol with a content of various impurities. The clinical picture, the course and treatment is similar to those with alcohol intoxication (see

When admitting inside - alcohol intoxication; Intensive scratching of skin and mucous membranes in blue color, persistent for 3-4 months. Differential diagnosis - methemoglobinemia.

Alcohol surrogates that do not contain ethyl alcohol and represents other single-nose or polyhydric alcohols (false surrogates) methyl alcohol (methanol, wood alcohol). The lethal dose at admission is about 100 ml (without preliminary ethanol reception).

Toxic blood concentration of 300 mg / l, mortal - more than 800 mg / l ethylene glycol refer to dihydroxyl higher alcohols; It is part of antifreeze and brake fluid. Female dose at admission inside - 100 ml.

Symptoms

Alcohol Surrogate Poisoning can be manifested in different ways, it directly depends on what was drunk and in what quantity. If it was a substance from the first group, then the most threatened for life will not be very large and poisoned in 9 cases out of 10 will safely be able to "pump out".

But if we are talking about the internal use of surrogates of the Group II, then the poisoning will proceed extremely difficult, and the consequences can be the most unpredictable.

To intoxicating alcoholic surrogates include such initial symptoms as:

• emotional arousal;
• reinforced motor activity;
• strong euphoria;
• dizziness, loss in space;
• redness of the skin of the face;
• abundant salivation;
• physical and emotional relaxation.

After some time, intoxication begins to manifest itself in the following symptoms:

• pale skin;
• strong dryness in the mouth;
• frequent urination;
• extended pupils that are not reacting to light;
• disturbed coordination of motility;
• affected nervous system;
• labored breathing;
• loss of ability for conversation and reasoning.

The first sign of alcohol poisoning is a loss of consciousness, deep sleep, coma. There are three stages of the comatose state with alcohol poisoning by severity.

Surface coma. Pupils are narrowed, but react to light.

From mouth - a sharp smell of that alcoholic beverage, which used to use the patient. When you try to lead to a sense of vapors of ammonia alcohol, the patient reacts with the corresponding grimace and protective movements of the hands, but does not come to himself.

The forecast is usually favorable. If in this stage the patient with the help of a gastric probe is to wash the stomach, then it quickly comes into consciousness.

Coma middle severity. It differs from the previous pronounced relaxation of the muscular tone.

The inhalation of the vapor of the ammonic alcohol reacts weakly. Washing the stomach does not bring the recovery of consciousness.

Such patients require hospitalization to toxicological separation. Deep coma.

Full absence of tendonflexes. The pupils were narrowed either (with respiratory impairment) wide and do not react to light.

Pain sensitivity and the reaction to the ammonia alcohol is absent. Emergency hospitalization is required to toxicological separation.

It should be known that all types of alcohol intoxication may be accompanied by the weavest of the language, which overlaps the access of air into the larynx and into the lungs, the ingress of mucus and the vomit in the respiratory tract.

The blood pressure of the state of light coma is usually increased, but in a state of deep coma it drops to critical numbers. Characteristic of the cheating of the pulse.

Alcohol to who should be distinguished from the cranial and brain injury (often in drunkenness there are a combination of them), from stroke, as well as from drug poisoning.

If the poisoned saws of surrogates with ethanol in the composition is still half-wing, although sometimes in these cases of poisoning are too hard. Of particular danger are alcohols from the group that does not contain ethanol. When poisoning them, a man first looks like with ordinary alcoholic intoxication:

• the face of drank blushing;
• a person becomes excited emotionally and physically;
• the state of Euphoria appears;
• sweating increases;
• salus is richly produced;
• the excitement is replaced by relaxation.

• skin pale;
• pupils are wider;
• in the mouth dries up;
• diuresis increases;
• movements become not coordinated, their amplitude is expanding;
• physical and mental activity is growing again;
• attention weakens;
• it becomes confused, illegible.

These symptoms of poisoning are still more like a strong degree of intoxication. However, when using different surrogates, signs will differ.

Methanol.

Quickly absorbing blood, methanol delivers a crushing blow to the kidneys and nervous system. As a result of the poisoning impact, a person will manifest characteristic symptoms:

• the visual nerve is affected;
• man is sick and tear;
• vision worsens (black dots appear, in the eyes two, the vision of objects becomes vague, the blindness can gradually develop);
• pupils are expanded, the answer to the light stimulus is insufficient.

After 1-2 days, other signs of poisoning with panneous vodka or other fake alcoholic beverages are added:

• the whole body hurts (lomit in the muscles, lower back and joints, felt cut and abdominal pain);
• the temperature rises to 38 ° C;
• pressure drops;
• there is a drying of mucous membranes and skin;
• heart works with interruptions;
• consciousness is bold;
• exculsions are agitated.

As symptoms increase without helping, a person comes, behind her - paralysis and death.

Ethylene glycol

This surrogate is also absorbed quickly, and the liver and kidney suffer from his poisoning. With severe intoxication, there is a damage to the nervous system. A clinical picture of increasing, respectively, three stages of poisoning:

1. Early. The first 12 hours after the use of surrogate alcohol, no symptoms of intoxication are not manifested. A person just looks drunk, but it is not yet complaining about.
2. Toxic damage to the nervous system. At this stage, there is a tear, there are headache complaints, thirst. Diarrhea appears, leather and mucous membranes acquire a bluish shade, the temperature rises and pupils are expanding. It was difficult to breathe well, the heart beats participated, the initiation phase occurs. If not to help, the victim will lose consciousness, and convulsions will begin.
3. Hepato and nephrotoxic stage. This stage begins for 2-3 days. A person has a kidney and liver. The skin turns yellow, it starts itching. Urine darkens, its development is reduced and disappears at all. The lack of liver and kidney develops, as a result of which the organs refuse.

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.

Poisoning of alcohol surrogates of the ICD 10 (international classification of diseases) is represented by codes T51.1 - T52.9.

Symptoms will depend, first of all, from the type of surrogate adopted. So, in people who poisoned alcohol with ethanol, the symptoms are not so dangerous. Surrogates, not containing ethyl alcohol, represent a greater danger.

In both cases, general symptoms will be nausea, vomiting, abdominal pain, a circling head. They look like those that are with ordinary poisoning. It is possible to determine the species of adopted surrogate according to the symptoms characteristic of each of them.

This poisoning is not so scary, compared with the poisoning of the surrogates of the second group, since ethanol is used for the manufacture of alcoholic beverages. First, the person is drunk, feels relaxed, peaceful, is in euphorical state.

With further use of surrogate, symptoms of ordinary poisoning are manifested as well as:

• Pale face, leather;
• Man more often wants to the toilet;
• Pupils are expanding;
• Dryness appears in the mouth, man is thirsty;
• A person cannot control his movements;
• It was difficult to speak, speech is confused;
• Possible confusion or loss of consciousness.

Methanol or wood alcohol acts on the body as psychotropic drugs. You can die, accepting only 50 millilitres of substances. Among the symptoms of poisoning, methanol can be allocated:

• Symptoms of ordinary poisoning: nausea, dizziness, etc.;
• Practically absent feeling of intoxication;
• Expansion of pupils that do not react to light;
• Vision problems: the inability to focus, black points before eyes, etc.;
• A few days after the patient's poisoning, pains of joints, muscles begin to disturb;
• The temperature rises;
• The skin becomes dry, like mucous mehers;
• Pressure decreases;
• The patient worries the heartbeat;
• Consciousness is confused;
• A person becomes excited, which may be accompanied by convulsions.

Ethylene glycol quickly spreads through the body, and the main blow is taken by the liver and kidneys, since it is through them a substance is derived. Ethylene glycol poisoning symptoms include:

• Feeling of intoxication in the first 12 hours, the lack of signs of poisoning;
• Next begins nausea, vomiting, diarrhea;
• The feeling of thirst appears;
• The skin acquires a blue tint, like mucous membranes;
• Pupils expand;
• The temperature rises;
• It becomes difficult to breathe;
• Heart patent.

If the patient did not apply for help or treatment does not help, his skin begins to yellow, kidneys and the liver to deny, the skin itches and darks urine. In this case, death is possible.

Russia is among the top ten countries of the world by the population abusing alcohol.

A huge number of deaths occurs from the poisoning of alcohol surrogates, the use of which leads to serious intoxication of the body, in most cases the ending death of a person.

Save people succeed rarely, because not everyone pays attention to the formidable symptoms of poisoning with pale water, the development of which quickly leads to a fatal outcome. Knowledge about how to render the affected help will save him from death.

What is surrogate alcohol

Alcohol drinks to change the emotional state to more comfortable. However, there are authorized by the state to use the inside the means that have been certified, and there are not at all intended for drinking.

Why do you need surrogate vodka and analogs? Such a "pumbled" product is cheaper than a certified, get it easier, and the effect of intoxication is almost the same. Surrogate poisoning according to the classification of codes according to ICD 10 refers to groups of diseases T5.1.1 - T5.2.

9. The surrogate alcohol includes:

• Chemical fluids containing ethyl alcohol as the main component - lotions, cosmetic and medicinal tinctures, denatures, technical alcohols, insects.
• Deceive, or false surrogates of alcohol-containing drinks, in which there is no ethanol, but there is methanol, dichloroethane, ethylene glycol.

The poisoning of the surrogate alcohol containing ethyl alcohol is very common, since alcoholics consider such liquids with the most safe for drinking.

However, all these substances are not intended for the human body, they are high a concentration of potent chemicals, the impact of which destroys the internal organs.

These include: glue based on BF, wipers, colognes, deodorants, mouth fresheners, other household chemicals, as part of ethyl alcohol.

False surrogats

The poisoning of alcohol surrogates, in which there is no ethyl alcohol, is considered the most severe and leads to almost instant death, since methyl alcohol, ethylene glycol is quickly absorbed by the organism and decompose into separate, extremely toxic substances.

At best, when using methyl alcohol, the alcoholic is separated by blindness. Ethylene glycol is part of the brake and defrosting fluid for machines, dichloroethane is a solvent of the adhesive base.

WHO is presented with impressive and scary figures - about 60% of men in Russia aged 15 to 60 die from intoxication by surrogates, which sharply reduces the age of recovering men to retirement in the country to 59 years instead of 75, such as in the UK.

Ethanol is a toxic substance, and alcohol poisoning and its surrogates depends on the individual reaction of the body. The deadly dose for any person is considered three bottles of brandy, drunk from an interval of less than 5 hours.

At the same time, doctors negotiate that for falsifications, the deadly dose may not exceed one pharynx, depending on the concentration of toxins in a substance that a person drinks.

Paradoxically, a non-harmonious snack can be given to death, since the body does not have time to cope with the incoming food, accumulating in the gastrointestinal tract, and the alcohol initially simply does not absorb, but then it goes into the blood in huge quantities, which can lead to a fatal outcome.

The mechanism of action of poison on the body

Each toxic substance acts in its own way to internal organs, however, since the poison passes through the digestive tract, all the gastrointestinal bodies are subject to danger, from the stomach from the kidneys.

Without coping with entering poisons, the gastric mucosa reacts with ulcers.

Approximately one-third of methanol and ethylene glycol are derived by the kidneys, which leads to acute insufficiency of organ functions, up to the absence of urination, the rest falls into the blood, causing a serious blow to the cells of the central nervous system, right up to the heart stop.

Signs of alcoholic poisoning

Of Frequently, the situation is when people buy a bottle of alcohol in the store, a marked and certified, which turns out to be "Painsen."

Remember the poisoning by surrogates, if alcohol drink in a funny company, it is difficult, especially if you consider that the first signs of the action of alcohol are euphoria, liberties, a raised mood.

And only a few hours after taking alcohol with poisonous impurities, the appearance of frightening symptoms of the hangover may indicate that the poisoning of alcohol surrogates occurred.

Ethyl alcohol

The poisoning of alcohol surrogates in most cases has a fatal outcome, if the victim does not provide emergency care on time. The poison quickly not only amazes the organs of the gastrointestinal tract, but also spreads blood throughout the body. A person is experiencing strong assets, the symptoms of which can be very painful.

Alcohol surrogates are conventionally divided into several types. The first is those that have ethyl alcohol. These can be cosmetics, liquids for cleaning household items.

The second type is surrogates that do not contain ethyl alcohol. These include means for processing materials against the negative effects of insects, mold, as well as dyes, adhesions. There is another third type. Called - false surrogates.

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.

Alcohol carries a considerable danger to the body. Using low quality product, you can not only choose, but also die.

The poisoning of alcohol surrogates according to statistics occurs quite often and often leads to irreparable consequences. For example, in Russia in 2011, about 11,700 people died on statistics from poisoning, but the true result exceeds this figure.

And every year the number of victims from surrogate is growing.

Symptoms in poisoning with surrogates differs, as it all depends on the type of substance and its quantity. A more favorable outlook for the use of low hazardous surrogates. And in case of methanol poisoning and ethylene glycol, the consequences are severe and most often comes to death.

Since there are 2 groups of surrogates, it is important to understand that the symptoms will be very different depending on the cause of poisoning. Even if it is known to which the group treated the surrogate, provoked poisoning (for example, it was a true surrogate), it is necessary to know which impurity is kept in the drink to competently assist the victim.

Symptoms of poisoning true surrogates

Signs of poisoning by surrogates are similar to the symptoms, which indicate that the patient used ethyl alcohol, but in the first case there is airsdown more pronounced and is observed after a shorter period of time. The consequences of poisoning with a base alcohol depend on the amount of alcohol taken inspired.

In poisoning with true surrogates, intoxication occurs due to toxic impurities. For example, after using hydrolysis alcohol, all the same symptoms are manifested as after using high-quality alcohol:

• nausea;
• vomiting;
• weakness;
• drowsiness;
• slow changes in blood pressure.

However, the speed of manifestation of the first signs is much higher. Incicacy is often registered when using medicines for a heart-based heart. In this case, the symptoms of poisoning will be added:

• bradycardia;
• decompensated violation of myocardial functions.

Surrogate alcohol poisoning is often provoked by the use of alcohol-containing means for outdoor use. In this case, the patient will have a sharp plany of the lips and mucous membranes, and the blood will become a more brown shade. This is due to the presence of anesthesine, which has a property to impede oxygen in the tissue and internal organs.

The use of alcohol in the form of cosmetic means leads to a violation of the functioning of the digestive tract along with signs of simple alcohol poisoning. This is due to the presence in most cosmetic products of butyl and methyl alcohols, which can lead to acute gastritis and even provoke the development of hepatitis.

When using the veil, the color of the mucous membranes is observed, but this is due to the presence of dyes in the composition.

The main harm of the mogon lies in the danger of sigh oil, which have an extremely devastating effect on the liver and lead to acute liver failure, and in the most running cases - even to cirrhosis. To provoke severe poisoning by the surrogates of this group, you need to drink a relatively small portion of alcoholic liquid.

Symptoms of poisoning with false surrogates

The most common "substitute" of ethyl alcohol is methyl, which in itself does not carry much harm to the human body. The main danger represents the products of its decay - formic acid and formaldehyde.

There is an opportunity to avoid acute poisoning with surrogate alcohol if ethyl alcohol will be present together with methylov. The thing is that ethanol - "antidote", preventing the transformation of methanol into substances harmful to the body.

Therefore, people suffering from chronic alcoholism mix two types of alcohol, however, such experiments are extremely dangerous to health.

A small dose of surrogate causes a slight step intoxication, during which a person feels satisfactory, only the main signs of alcohol intoxication appear. Poisoning of poor quality alcohol occurs at the end of this "hidden" period.

If the amount of accepted alcohol is slightly larger, signs of intoxication appear instantly: in just a few hours there may be a fatal outcome, if a person will not be given proper help.

At easy and moderate, poisoning are observed:

• sharp impairment with subsequent recovery;
• dizziness;
• nausea.

With a severe stage, there are very pronounced symptoms of acute alcohol poisoning. A person can fall into alcohol to anyone 2 hours after the manifestation of the first symptoms:

• drowsiness;
• violation of self-control;
• sharp changes hell;
• severe thirst;
• sustainacles.

Another common ethyl alcohol surrogate is ethylene glycol, which is present in the brake fluid. Danger represents the decay products of this substance, the most toxic of which is oxalic acid, causing the destruction of the kidneys. Basic symptoms:

• redness of the skin;
• changing the color of the mucous
• an increase in heart rate;
• hyperthermia;
• violation of the perception of the surrounding world;
• psychomotor disorders;
• cramps.

Sorrelic acid leads to acute heart failure, disrupts the liver and provokes acute renal failurewhich acts as the most common cause of death in human poisoning ethylene glycol.

In the first signs of poisoning by surrogates, it is necessary to seek qualified help, since malaise progresses with very high speed. The first help should be washed with a stomach with warm water.

Further measures treatment directly depend on the cause of poisoning:

1. Methanol. Apply ethanol in small doses, which prevents the splitting of methanol. Atropin and prednisone are used to restore vision.
2. Ethylene glycol. A sodium bicarbonate solution is used. Need to adjust water-electrolyte balance And drink diuretics to restore the work of the kidneys.
3. True surrogates. Here the treatment is appointed depending on which organs and systems of the body are injured. It all depends on the amount of accepted alcohol and its kind.

Alcohol poisoning and any kind of surrogates can be extremely dangerous. Surrogate alcohol very often leads to death, and many people who have been treated after surrogate poisoning become disabled. It is important to protect a person from drinking such alcohol.

Surrogate alcohol has become a real national problem in connection with the frequent cases of poisoning toxic compounds instead of alcoholic beverages.

Late stages of alcoholism are characterized by degradation of the personality and thinking, which leads to ill-conceived actions, including the separation of cheap products, unsuitable for food consumption and life-threatening.

The effect of surrogate mortality alcohol

Toxic doses

Surrogate alcohol has become a real national problem in connection with the frequent cases of poisoning toxic compounds instead of alcoholic beverages. Late stages of alcoholism are characterized by degradation of the personality and thinking, which leads to ill-conceived actions, including the separation of cheap products, unsuitable for food consumption and life-threatening.

However, not only chronic alcoholism can cause poisoning - illegally made low-quality products can be found on store shelves under a harmless label.

The poisoning of alcohol and its surrogates is accompanied by a rapid loss of consciousness, the development of a comporaous and comatose state. First of all, the brain and blood circulation system suffer from toxic drinks, therefore, in addition to disturbances of consciousness, the symptoms are accompanied by breathing problems and vessels.

The clinical picture of poisoning may differ slightly - it all depends on the type of product, which caused it. Thus, the poisoning of the moonshine is accompanied by persistent irreversible changes, since this high-tech alcoholic surrogate contains a number of heavy and dangerous compounds.

The main risk of poor-quality alcohol is due to the sigh oil, from which it is either not cleared at all, as in the case of the moonshine, or is considered partially. Moreover, it is very difficult to clean the pawny vodka or moonshine at home from the sigh oil.

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.

The light shape of the poisoning of alcohol surrogates is manifested by nausea, repeated vomiting, headache, dizziness, pain in epigastria, expressed vision disorders - flickering of 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.

The reasons

The cause of severe poisoning and death of a person can be a one-time consumption of surrogates in a large dosage or their regular use over long years. The predisposing factors are:

• asocial lifestyle;
• bad Company;
• alcohol addiction;
• burdened heredity;
• addiction;
• lack of permanent residence;
• heavy family incidents.

Ethanol

1.2 etiology and pathogenesis

The alcohols included in the T51 group are characterized by limited volatility and with relatively low toxicity of acute inhalation poisoning with alcohols in clinical practice practically do not occur with the exception of the cases of the inhalation use of some alcohols (isopropyl) and some technical recipes containing alcohols for the purpose of narcotic intoxication.

Most often in clinical practice there are sharp oral poisoning with alcohols used for the purpose of alcohol intoxication.

Acute alcohol poisoning usually occur when taking ethyl alcohol or various alcoholic beverages with an ethyl alcohol content of more than 12%. The deadly dose of 96% ethanol ranges from 4 to 12 g per 1 kg of body weight (approximately 700-1000 ml of vodka in the absence of tolerance).

Alcoholic coma comes at the concentration of ethanol in the blood of 3 years and above, death - at a concentration of 5-6 bonds and above. Poisoning, as a rule, are the nature of household - random, with the purpose of intoxication.

Poisoning with pure high alcohols - propyl, butyl, amylovy are found in toxicological practice much less often than ethyl alcohol, more often there are poisoning them with ethyl alcohol.

Deadly doses and concentrations: cases of death poisoning are described when taking inside - 0.1-0.4 liters of propyl alcohol and more. Death has occurred in a period of 4-6 hours to 15 days, a coma - in the blood content of propanol about 150 mg%.

However, death poisoning is described and when taken inside with 40 ml of alcohol. The isopropyl alcohol (LD100) of isopropyl alcohol (LD100) is considered to be 240 ml, the levels of mortal concentrations vary from 0.04 mg / l in children and 4.4 mg / l in adults.

Ways of admission to the body - inhalation, oral, percutter, however, in clinical practice, poisoning predominate as a result of oral administration of these alcohols.

1.3 Epidemiology

Acute ES poisoning are one of the leading reasons for emergency hospitalization about poisoning. According to reports of toxicological centers of Russia (form No. 64), patients with this pathology amounted to 37.

9%, 30.7%. All those hospitalized in these divisions in 2008 - 2011, respectively.

In 2015, this indicator was an average of 32.7%. By federal Districts The proportion of patients hospitalized with ethanol poisoning in 2015 ranged from 7.1% in the North-West Federal District, up to 69% in the Ural and Siberian FD.

Hospital mortality on average with ethanol poisoning was 3.0% in 2005-2012, in 2015 - 4.7%. Mortality as a result of ethanol poisoning in relation to other reasons for fatal outcomes in poisoning in the Russian Federation is the leading factor in the same period amounted to from 55.8% in 2005 to 42.1% in 2012, 2015 - 43, 7%, other alcohols - 3.3% - 4.0%.

Criteria for assessing the quality of medical care

Classification

Coma classification due to toxic effects (acute poisoning) ethanol, which is divided in depth, respectively

coma superficial is not complicated,

coma superficial complicated,

coma deep not complicated

coma deep complicated.

Toxic action of alcohols:

2-propanol (propyl alcohol),

suggest oils (alcohol: amylovoy;

butyl; Propyl

classified by severity:

easy - not accompanied by loss of consciousness,

medium severity - with a disorder of consciousness according to the state of the copor state, toxic encephalopathy, but without complications,

heavy - characterized by the complete loss of consciousness (coma), which may be accompanied by various complications.

First group

Low hazard

Low hazard

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.

Diagnostics

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:

• general urine analysis;
• general and biochemical blood test;
• electrocardiogram;
• Ultrasound abdominal cavities, hearts;
• 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.

2.3.1 Chemical-toxicological laboratory diagnostics

The basis is chemical-toxicological laboratory diagnostics. It is not recommended to use for the purpose of diagnosing the definition of the presence and level of ES blood using an exhaled air analysis (an alkometter), since this method does not allow to determine the presence of other alcohols, is inferior to the accuracy of GLC, and also does not allow to obtain the required amount of exhaled air (the most complete Active exhalation) in a patient in a state of coma).

The definition of ethyl alcohol in blood and the urine is recommended to carry out 2 times at an interval of 1 hour in order to confirm the result of the first study and determining the phase of poisoning in the ratio of the ethanol concentration in these biosrods (resorption or elimination).

The tool diagnosis of the specifics does not have and is carried out in order to differential diagnosis and monitoring the patient's condition.

electrocardiography (ECG) - the likelihood of having cardiomyopathy, chronic heart disease (especially since the history of life of such patients when entering the hospital is practically not known),

radiography of the chest organs,

skull radiography in two projections - patients delivered from the street, public places, with traces of injury.

ezophagogastroduodenoscopy (EGDS) - Higher alcohols have a local irritant effect on the mucous membrane of the digestive tract (the multiplicity of up to 2 times).

Additional instrumental diagnostic methods are recommended to be carried out once in order to identify injury, concomitant pathology or possible complication (Ultrasonic Study (Ultrasound) (ECHO-Skopia) of the brain, computed tomography (CT) and magnetic resonance tomography (MRI) brain, ultrasound of the abdominal cavity organs, kidney, pancreas, fibrobronchoscopy FBS.

At the stage of primary health care, it is recommended to exclude diseases or conditions that caused to someone on the background of alcohol intoxication, in particular:

card-brain injury, acute violation of cerebral circulation;

hypoglycemic coma;

infectious disease (meningitis, encephalitis, etc.)

hepatic and uremic koma, coma in endocrinological diseases, severe encephalopathy with water-electrolyte and metabolic disorders.

In the hospital in the patient's admission, it is also recommended to eliminate the above disease or state, and in the absence of positive dynamics 2.0-4.0 hours after the start of infusion therapy, a more in-depth study was recommended, including chemical-toxicological to eliminate the presence of a combined reception of any -Lo psychotropic agents or other somatic or infectious disease.

Previously, doctors first survey witnesses of poisoning, they will examine the victim himself. If necessary, medical care will be rendered in place, after which the patient will be transported to the hospital for further examination:

• blood test from veins to detect alcohol, which contained chopped pale vodka;
• blood on the detection of methanol;
• ECG to study the activity of the heart (whether the rhythm is not disturbed, is there any damage to myocardium, etc.).

After the diagnosis, when a specific surrogate is known and identified the true picture of the patient's condition, doctors will prescribe a targeted treatment.

Methods of research EEG ECG (decrease in the S-T segment, negative teeth, extrasystolia; with alcoholic cardiomyopathy, resistant rhythm and conductivity violations are possible) microfi diffusion test and gas-liquid chromatography - tests for the presence of ethanol in the blood.

Differential diagnosis of CHMT acute violation of the cerebral circulation of poisoning with false alcohol surrogates (chlorinated hydrocarbons, methanol, ethylene glycol) poisoning with sleeping drugs, drugs and tranquilizers Hyoglycemic coma.

Methods of research EEG gas-liquid chromatography. Differential diagnosis is carried out with acute alcohol poisoning.

Treatment of maintenance (CM The absence of positive dynamics of the state of the patient for 3 hours against the background of the therapy testifies to unrecognized complications (CHMT, alteectase of lungs, etc.) or an erroneous diagnosis.

Toxic doses

2.1 Complaints and history

When poisoning with ethanol, the complaint is practically absent, since the patient is unconscious. When poisoning with higher alcohols, with the saved consciousness, the complaints are characteristic of the effects of drugs of narcotic and irritating: weakness, dizziness, headache, pain in the epigastric region, nausea, vomiting.

When poisoning with butanol, amyl alcohols may be complaints about diarrhea.

Anamnesis should be aimed at clarifying the following data: Type of toxic substance (vodka, wine, beer, technical alcohol, solvent - its name, trademark, etc.), dose, time of receiving toxicant.

In addition, it is advisable to find out some of the history of life: transferred diseases, injuries, bad habits.

2.2 Physical examination

When poisoning with ethanol, higher alcohols are recommended to evaluate the following:

The appearance of the skin - the specific color is absent, with a breath impairment, the shock is marked by the cyanosis of the lips, the face, acricyanosis, cooling, with deep coma there may be humidity. It is necessary to identify the presence / absence of rash, local changes, the so-called. "Laying out" due to positional injury due to pressure of a mass of own body, the so-called positional pressure on certain sections of soft tissues leading to the appearance of areas of hyperemia of the skin, which are often regarded as bruises, hematomas, burns, phlebitis, allergic swelling, etc. And usually detected in early terms (1-3 days).

Assess the psychoneurological status: the state of consciousness (clear, inhibition, copor, coma, psychomotor arousal, hallucination). If there are coma to assess its depth, the presence or absence of reflexes, the width of pupils, their reaction to the light, the presence (absence) of the anisocoria, the state of the muscular tone. When identifying anisocoria, pathological reflexes pay attention to their consistency ("the game of pupils"), since with surface alcohol coma, anisocorium and pathological reflexes can appear and quickly disappear.

Assess the condition of breathing: adequacy, frequency, depth, uniformity of participation in the act of breathing of all chest departments, auscultatory picture.

Inspect the visible mucous membranes - some higher alcohols have annoying properties and moor cause a feeling of burning, soreness when swallowing.

Pay attention to the presence / absence of damage, especially in the area of \u200b\u200bthe face, head, abdomen, lower back.

Pay attention to the presence / absence from exhaled smell air characteristic of ES, higher alcohols, but is not an absolute fact confirming ES poisoning, since the state of alcohol intoxication can accompany various somatic, infectious diseasesInjuries.

Pharmacodynamics

Nootropics.

Pharmacological action - nootropic. Pharmacodynamics.

Piracetam binds to the polar heads of phospholipids and forms mobile complexes of piracetam phospholipids. As a result, the two-layer structure of the cell membrane and its stability is restored, which in turn leads to the restoration of the three-dimensional structure of membrane and transmembrane proteins and the restoration of their function.

At the neuronal level, piracetam facilitates various types of synaptic transmission, providing a predominant effect on the density and activity of postsynaptic receptors (data obtained in animal studies).

Improves the links between the hemispheres of the brain and synaptic conductivity in non-Russian structures improves brain blood flow. It has an action on the CNS in various ways: modifies neurotransmission in the brain, improves metabolic conditions that contribute to neuronal plasticity, improves microcirculation, affecting the rheological characteristics of the blood and without causing vasodilation.

Under cerebral dysfunction increases the concentration of attention and improves cognitive functions, in the PM, the ability to learn, memory, attention and consciousness, mental performance, without providing a sedative or psychostimulating impact.

The use of piracetam is accompanied by significant changes in EEG (an increase in α- and β-activity, a decrease in δ activity). It creates the restoration of cognitive abilities after various cerebral damage due to hypoxia, intoxication or electrosalproof therapy.

It is shown for the treatment of cortical myoclonia, both as monotherapy and as part of comprehensive therapy. Reduces the duration of the vestibular neuronit and nystagma.

The hemorographic effects of piracetam are associated with its influence on red blood cells, platelets and vessel wall. In patients with sickle-shaped anemia during the pathological rigidity of red blood cells, piracetam restores the elasticity of the erythrocyte membrane, increases their ability to deformation and filtration, reduces blood viscosity and prevents the formation of coin columns.

In addition, it inhibits increased aggregation of activated platelets, without affecting their number. At a dose of 9.6 g, the level of fibrinogen and Willebrand factor is 30-40% and lengthens the bleeding time.

In animal studies, it is shown that piracetam inhibits spasm of vessels and counteracts various vasospast substances. In research on healthy volunteers, piracetam reduced the adhesion of erythrocytes to the endothelium of the vessels and stimulated the production of prostacyclinins in the endothelium.

Nosology

A89 Viral infection of the central nervous system uncomfortable. D57 Sick-shaped cellular disorders.

F00 Dementia in Alzheimer's disease (G30). F01 vascular dementia.

F03 Dementia is unspecified. F04 Organic amnistic syndrome, not caused by alcohol or other psychoactive substances.

F05 Delium, not caused by alcohol or other psychoactive substances. F06.7 Easy cognitive disorder.

F07.1 posturedencephaal syndrome. F07.2 postcontezion syndrome.

F07.9 Organic personality disorder and behavior, due to the disease, damage or dysfunction of the brain, unspecified. F09 Organic or symptomatic mental disorder is unspecified.

F10.2 alcohol dependence syndrome. F10.3 abstinence.

F10.4 abstinence with delirium. F10.5 psychosis alcoholic.

F11 Mental and behavioral disorders caused by the use of opioids. F13 Mental and behavioral disorders caused by the use of sedative or sleeping pores.

F29 Inorganic psychosis is unspecified. F32 depressive episode.

F34.1 Distimia. F41.2 Mixed anxious and depressive disorder.

F48.0 nestration. F60.3 Emotionally unstable personality disorder.

F63 disorders of habits and deposits. F79 mental backwardness is unspecified.

F80 Specific speech and language development disorders. F90.0 Violation of activity and attention.

F91 Behavior Disorder. G21.8 Other forms of secondary parkinsonism.

G25.3 Miklonus. G30 Alzheimer's disease.

G40.9 Epilepsy is unspecified. G46 vascular brain syndromes with cerebrovascular diseases.

G80 Child cerebral paralysis. G93.4 Encephalopathy uncomfortable.

H55 Nistagm and other involuntary eye movements. I61 intracerebral hemorrhage.

I63 brain infarction. I67.2 cerebral atherosclerosis.

I69 The consequences of cerebrovascular diseases. P15 Other generic injuries.

P91 Other violations of cerebral status in a newborn. R26,8 Other and unspecified violations of gait and mobility.

R40.2 coma is unspecified. R41.0 Orientation violation uncomfortable.

R41.3. 0 * Reduced memory.

R41.8. 0 * Disorders of intellectual-moon.

R42 Dizziness and disruptability. R45.1 Anxiety and excitement.

R46.4 Inhibition and slow motion reaction. R47.0 Dysfasia and aphasia.

R51 Headache. R53 Hasive and fatigue.

R54 Old age. S06 intracranial injury.

T40 drug poisoning and psychodisleps [hallucinogens]. T42.3 Barbiturate Poisoning.

T51 Toxic action of alcohol. Z55 Problems associated with learning and literacy.

Alcohol classification: Code of ICD-10

This page contains all ICD-10 codes affecting alcohol and consequences of its use. Alcoholism, intoxication, poisoning, delirium and other diseases and their codes in accordance with the International Classification of Diseases of the 10th Revision.

Associated with the use of alcohol disease is located under codes Z 71.4, Z 50.2, Z 72.1, Z 81.1, block F10.0-F11 (alcoholism and chronic alcoholism) and other codes classifying associated with alcohol abuse.

Classification of alcoholism on the ICD-10:

Z71.4 - Consulting and observation about alcoholism

The diagnosis "Consulting and observation of alcoholism" is made by women by 34% more often than men. Diagnosis code for ICD-10 Z71.4.

At the moment, the diagnosis is delivered by more than 14,000 people, while the 0% mortality rate of patients with this diagnosis is recorded. This does not mean that alcoholism is not dangerous - most patients with this diagnosis systematically deal with solving problems with alcohol dependence than the statistically zero risk of death is due. If there are more serious states, another diagnosis with the corresponding codes is set.

Z50.2 - Rehabilitation of persons suffering from alcoholism

During the rehabilitation of alcohol dependence, the code Z50.2 is assigned. In ICB-10, the Z50 section describes as "assistance, including the use of rehabilitation procedures."

In the process of rehabilitation of the patient, various drugs can be assigned to restore the condition of the body (anxiolitics, fosenazid (FOSENAZIDE) and others). The exact methods of treatment and the relevance of the formulation of this diagnosis depend on the state of the patient, the flow of alcoholism, anamnesis.

Q86.0 - Alcoholic fetal syndrome (donormorphia)

The fetus dyshorphia is classified in the ICD-10 in the class "Q00-Q99 congenital anomalies [Development Vices], deformation and chromosomal disorders".

The alcohol syndrome in the fetus (donormorphia) occurs in the case of long-term abuse of a woman with a woman during pregnancy and before it. Development defects and congenital pathologies may look different, depending on the set of conditions, the main of which is the number and systematics of a used alcohol. The cause of the disease is the toxic effect of acetaldehyde and other products of the decay of alcohol entering the child's body through the mother.

The symptoms of alcohol donormophy of the fetus are represented by four basic groups of deviations:

1. Card-facial donorphia.
2. Prenatal and postnatal doesorphia.
3. Brain damage.
4. Somatic deformities.

Unfortunately, almost all pathologies manifest themselves from birth and practically do not treat themselves. Damage to the nervous system caused by the inability of the child's body to process alcohol is manifested immediately (this applies to tremor and other visible deviations). The treatment is symptomatic and is directed to the maximum getting rid of suffering. Children with such a diagnosis requires significant social and legal assistance and support.

G31.2 - The degeneration of the nervous system caused by alcohol

Long-term abuse of alcoholic beverage causes irreversible degenerative damage to the nervous system. The disease is described in the ICD-10 in the class G00-G99 "Nervous System Diseases", the G30-G32 block "other degenerative diseases of the nervous system".

Read more about nerve damages, possible consequences and restore the nervous system after alcoholism read in the article "The Effect of Alcohol on nervous system: How to restore nerves? "

P04.3 - fetal lesions and newborn, due to consumption by the mother of alcohol

The fetus dyshorphia is far from the only consequence of drinking alcohol during pregnancy. Code P04.3 refers to the class P00-P96 "Separate states arising in the perinatal period".

Dimorphia (Alcohol Syndrome in the Fetal) from the category was excluded because he received a separate Q86.0 code in the classification of disease. As in the case of alcohol syndrome, all damage occur for two reasons:

Y57.3 - Special means for the treatment of alcoholism, causing alcohol intolerance

The code Y57.3 refers to the external causes of morbidity and mortality, to the Y40-Y59 unit "drugs, medicines and biological substances that are the cause of adverse reactions with therapeutic use." In this case, drugs with a negative effect are special means for the treatment of alcoholism, causing alcohol intolerance.

Similar medicinal and folk coding methods have high efficiencySince the patient physically will not be able to eat alcohol due to the extremely negative and painful reaction of the body. Heavy health effects and the possibility of fatal outcome usually occur when the patient tries to eat alcohol contrary to the prohibitions of doctors. Much less often there are cases of accidental alcohol entering blood together with medicines or products.

T51 - Toxic Action of Alcohol

The toxic effect of alcohol and poisoning of alcohol surrogates in the ICD-10 is described under the code T51. The detailed content of the T51 section is available in the article toxic effect of alcohol, and surrogate poisoning.

Codes MKB-10 for alcohol surrogates:

The following diseases were excluded from the T51 section and were transferred to the F10 code:

F10.2-F11 - alcoholism and chronic alcoholism

According to the order of the Ministry of Health of the Russian Federation No. 140 dated 04.28.1998, the classification of alcoholism should be made using the codes below International Classification Diseases of the 10th revision. The specific code is made depending on the history of the disease, the severity of the dependence, the degree of behavioral, physical and psychological damage in the body.

F10.0 - acute intoxication
In the ICD-10, acute alcohol intoxication refers to the section F10 "Mental and behavioral disorders caused by alcohol use". The diagnosis is made due to the complex physical, psychological and behavioral changes and the consequences arising from the excessive use of alcoholic beverages.

The diagnosis of acute intoxication can be supplied as alcoholics, there and people without dependence on alcohol at all. The severity of intoxication depends on the amount of drank and individual reaction of the body. In most cases, intoxication requires only simple household measures and causes a hangover. IN acute form Heavy help, dropper, cleaning the body and other detoxification events may be required.

The main symptoms of severe intoxication followed by acute intoxication:

F10.1 - Dear consumption, alcohol abuse
Under dismissal use is the abuse of alcohol, causing pronounced negative effects to health.

Code F10.1 includes systematic use of alcohol over the past year and more. When such abuse is not yet accompanied by the formation of alcohol dependence (aclaogolism), but at the same time causes physical damage to health. The social side of the issue is not considered in this case.

F10.2.4.1 - Chronic alcoholism (alcohol dependence)
The initial stage of alcoholism in the aggravation phase is implied. At this stage of the development of the disease, all the symptoms of alcohol dependence are present. Usually, exacerbations occur when for some reason the dependent person does not physically obtain a long time to get the desired alcohol.

For the initial stage of addiction, the following manifestations are characteristic:

One of the characteristic differences in the first stage of the dependence on alcohol: an increased thrust for alcohol is already there, but there is still no abstineent syndrome.

F10.2.2.1 - Initial stage of chronic alcoholism, supporting treatment phase
For the current stage, the following symptoms of alcohol dependence are characteristic:

F10.3 - Average Stage of Alcohol Dependency (Easy, Medium, Heavy Degree)
Code F10.3 (F10.2.4.2) is assigned in the presence of a patient with alcohol (chronic alcoholism) average stage - when the disease is in the exacerbation phase, there is an abstineent syndrome.

Symptoms of alcoholism of the middle stage, easy degree gravity ::

At this stage, the patients are extremely difficult to refuse alcohol independently. Without the treatment and correction of behavior, alcoholism will continue to progress.

The symptoms of the middle stage in exacerbation middle degree Severity:

The thrust for alcohol becomes even stronger, the patient turns out to be practically unable to control it.

Symptoms of the middle stage of alcoholism in the phase heavy degree Exacerbations:

With a severe degree of abstinence syndrome, active attractions take into alcohol. Alone, the alcoholic is no longer abandoning the alcohol almost never, with the exception of critical situations and circumstances (and the fact that the opportunity does not appear).

F10.2.2.2 - Medium stage of chronic alcoholism supporting treatment
Supporting treatment in the middle stage of alcohol addiction implies a stable satisfactory condition of the patient.

Classical clinical picture:

In such a state, the patient can feel quite well and adequately lead, but at the same time the installation on a sober lifestyle is perceived passively.

F10.2.4.3 - Finite stage of chronic alcoholism, aggravation with heavy bypass syndrome
The general code of the disease according to the ICD-10 remains the same (F10.3). The clarifying code - F10.2.4.3 is assigned at the final stage of alcohol dependence, in the exacerbation phase with a severe degree of abstinence syndrome. Lightweight and medium severity of abstinence for this stage of alcohol addiction is uncharacteristic.

For this phase, the following symptoms are characteristic:

• Strong feeling of guilt and anxiety, fears, insomnia.
• Dizziness, headaches, embarrassed contact with people.
• Chills, strong sweating (especially at night), nausea and vomiting.
• Student heartbeat, Tremera of the whole body.
• The episodic appearance of hallucinations and illusions.
• Motor anxiety, shimmering disorientation.

At the final stage of alcoholism, the patient has an active attraction to alcohol. It is no longer able to control the alcohol to alcohol and abandon the alcohol patient.

F10.2.3.3 - The final stage of alcoholism, therapeutic remission against the background of the adversis
Due to the treatment with obverse drugs, therapeutic remission can be achieved at the final stage.

Against the background of remission:

• There is a partial reduction of neurological and somatic symptoms.
• The patient remains persistent psychopathological disorders.
• Against the background of general improvement in well-being, patients manage to instill formal facilities for sobriety and further treatment.

F10.4 - Alcohol Cancellation Status with Deliirius (Alcohol Delium, White Hard)
According to the ICD-10, the cancellation syndrome with delirium (white hot) is assigned the code F10.4. Acute psyche disorder appearing at the final stages of alcoholism against the background of abolition of alcohol - stopping the use of alcoholic beverages.

Symptoms of alcohol cancellation syndrome with Delirius:

• Chills, increase body temperature.
• Rave; Hearing, sound and tactile hallucinations.
• Dysorientation in space and self.

White hotness often ends with death without proper treatment, including due to independent damage to the patient himself. Hallucinations when canceling alcohol with delirium are threatening: small, dangerous and terrible things are often measured - insects, devils.

Alcohol delirium develops very sharply during alcohol consumption. It is most strongly subject to persons on 2 and 3 stages of alcoholism, after stopping the taking alcohol for 2-5 days. Statistically, to reach this extent, a person has to systematically consume a large amount of alcohol, being in 2 or 3 stages of the disease.

F10.5.2 - Acute and subacute alcoholic hallucinosis
The code is assigned to alcoholic psychotic disorders, preferably hallucinatory. Acute and subacute alcoholic hallucinia differs in the following symptoms:

• The state of acute mental disorder.
• Pronounced motor anxiety.
• Strong fear, anxiety, emotional experiences.
• Attempts to take direct participation in painful experiences and hallucinations.

F10.5.1 - Alcohol psychotic disorder, mainly delusional
This COB-10 code is assigned in the following states developing against the background of chronic alcoholism:

• Alcoholic paranoia.
• Alcohol paranoid.
• Alcoholic Brad of Jealousy.

Alcoholic delusional psychotic disorder is characterized by the following symptoms:

• Strong feeling of fear.
• Nonsense on the topic of relationships and jealousy.
• Paranoia, obsessive thoughts about persecution.

F 10.6 (F10.5.3) - Alcohol psychotic disorder, mainly polymorphic, with an outcome in amnesian syndrome
Disorders suitable for classification: alcoholic encephalopathy, Corsakovsky psychosis.

• Disorientation, inadequate and unproductive behavior, misunderstanding of the location.
• The ability to memorize events disappears: the patient may forget that married or has a child.
• Summary, tactile and auditory hallucinations.

In this stage, an alcoholic disease communicates with all people as if she sees them for the first time (if the person appeared during the development of psychosis). The resulting process of atrophy of the peripheric nerves leads to frequent unpleasant hallucinations: the patient seems to be rushing on his body, spiders and other insects are crawling.

Alcoholism. Classification.

Since 1998 in Russia acts "International statistical classification of diseases and health problems", abbreviated ICD - 10 .

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Definition and general information [edit]

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Etiology and pathogenesis [edit]

Clinical manifestations [edit]

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Differential diagnosis [edit]

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